{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T04:27:51Z","timestamp":1791001671450,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The value of proximal bone analysis for surgical clearance of infection remains debated. Real\u2010world practice traditionally utilized proximal bone microbiology rather than histopathology to diagnose residual diabetes\u2010related osteomyelitis of the foot (DFO) post\u2010amputation. We assessed the concordance between proximal bone microbiology and histopathology in determining residual infection and their predictability for revision operation in DFO and diabetes\u2010related foot infection (DFI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>A single\u2010centre retrospective study was conducted between June and December 2020 at a tertiary institution. We recruited patients with diabetes mellitus who had minor amputations for DFO and DFI and analyzed their proximal bone microbiology, histopathology and outcomes at 6\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010four patients were recruited; 64 (76.2%) were male. The mean age was 69.3\u2009years. The mean HbA1c was 8.6%. Seventy\u2010seven operations were performed for DFO and 17 for DFI. Negative microbiology showed complete concordance with histopathology; and none had revision operation (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.99). Positive microbiology had 9.8% concordance with histopathology (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.99). Positive histopathology was associated with a higher rate of revision operation (80% vs. 12.5%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01). High preoperative C\u2010reactive protein was associated with residual DFO (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.02) and revision operation (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Positive histopathology was more reliable for determining significant residual DFO and predicting revision operation. Positive microbiology was valuable for guiding antibiotic selection. We suggest routine proximal bone analysis for both histopathology and microbiology to optimize the treatment of DFO and DFI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.18805","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T22:44:23Z","timestamp":1701297863000},"page":"445-450","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of routine proximal bone analysis for microbiology and histopathology in diabetes\u2010related foot infections and osteomyelitis"],"prefix":"10.1111","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1427-5796","authenticated-orcid":false,"given":"LongHai","family":"Jin","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery The Canberra Hospital  Garran Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0334-360X","authenticated-orcid":false,"given":"Rong Xian","family":"Chia","sequence":"additional","affiliation":[{"name":"Department of General Surgery The Canberra Hospital  Garran Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendell","family":"Neilson","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery The Canberra Hospital  Garran Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hardman","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery The Canberra Hospital  Garran Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert","family":"Frahm\u2010Jensen","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery The Canberra Hospital  Garran Australian Capital Territory Australia"},{"name":"School of Medicine and Psychology Australian National University  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alister","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery The Canberra Hospital  Garran Australian Capital Territory Australia"},{"name":"School of Medicine and Psychology Australian National University  Canberra Australian Capital Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-71908-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S181198"},{"key":"e_1_2_8_5_1","unstructured":"Diabetic Foot Australia.DFA Guides You Through: The Estimated Burden of Diabetes\u2010Related Foot Disease in Australia in 2017.2017."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3654"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3657"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0976-1"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2013.06.010"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-1526"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2010.12.009"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2012.06.017"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2018.12.012"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1938640018770285"},{"key":"e_1_2_8_15_1","article-title":"Outcomes of limb\u2010sparing surgery for osteomyelitis in the diabetic foot: importance of the histopathologic margin. Open forum","volume":"6","author":"Johnson MJ","year":"2019","journal-title":"Infect. Dis."},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734616661058"},{"key":"e_1_2_8_17_1","article-title":"Evaluating predictive value of surgical resected proximal bone margins in diabetic foot osteomyelitis with clinical outcomes at 1 year. Open forum","volume":"10","author":"Weng B","year":"2022","journal-title":"Infect. Dis."}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.18805","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T13:19:23Z","timestamp":1710854363000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.18805"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,29]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1111\/ans.18805"],"URL":"https:\/\/doi.org\/10.1111\/ans.18805","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,29]]},"assertion":[{"value":"2022-01-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}