{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:38:37Z","timestamp":1763037517524,"version":"3.41.2"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the impact of surgical debridement on the microbiology of resection margins of an infected diabetic foot ulcer and to compare the use of marginal sampling as a guide for antimicrobial therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty consecutive participants were studied. Tissue samples from infected diabetic foot ulcers were obtained at first contact by podiatrists. After surgical debridement to macroscopically healthy tissue, multiple samples were obtained from the margins of the residuum and also from excised non\u2010viable tissue. Debridement was done by a single surgeon. Bacterial species were classified according to pathogenic potential a priori into Red Group\u2014Definite pathogen causing infection, Yellow Group\u2014Likely to be causing infection if present in more than one specimen and Green Group \u2013Commensals, not causing infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a relative reduction of 49% (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002) in bacteria in the most pathogenic (red) group, and 59% (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002) in the yellow group in podiatry samples compared with resection specimen. Positive cultures from margins of the residuum were observed in 75% of cases. There was a relative reduction of 67% (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0001) in bacteria in the red and 48% (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.06) in the yellow group in marginal samples from the residuum compared with podiatry samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>After surgical debridement to healthy tissue, positive cultures from marginal tissue samples provided vital information on the presence of pathogenic bacteria. This allowed antibiotics to be individualised post\u2010surgical debridement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14440","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T21:06:19Z","timestamp":1603919179000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Microbiological evaluation of resection margins of the infected diabetic foot ulcer"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0005-5872","authenticated-orcid":false,"given":"Mavin","family":"Macauley","sequence":"first","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Adams","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Mackenny","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"},{"name":"Orthopaedic Department Hartlepool North Tees and Hartlepool NHS Foundation Trust Hartlepool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Kubelka","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Scott","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Buckworth","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Biddiscombe","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Aitkins","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Lake","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicky","family":"Matthews","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suhel","family":"Ashraff","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Ashwell","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology South Tees Hospitals NHS Trust Middlesbrough Teesside UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-006-0491-1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-020-00383-2"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110079501600702"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/383275"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(96)80075-5"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.8.851"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019437"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-200106000-00002"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2004.01358.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-1526"},{"key":"e_1_2_9_13_1","unstructured":"LipskyBA Senneville\u00c9 AbbasZG et al.IWGDF Guideline on the diagnosis and treatment of foot infection in persons with diabetes page 6 [Internet].https:\/\/iwgdfguidelines.org\/wp\u2010content\/uploads\/2019\/05\/05\u2010IWGDF\u2010infection\u2010guideline\u20102019.pdf.2019[cited 2020 Jan 1]."},{"key":"e_1_2_9_14_1","unstructured":"PHE.Investigation of bone and soft tissue associated with osteomyelitis. 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