{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:15:36Z","timestamp":1784128536634,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To determine the frequency of osteomyelitis in diabetic foot ulcers (DFUs) and its outcomes in association with lower extremity amputation (LEA). This prospective cohort study was conducted at the Baqai Institute of Diabetology and Endocrinology, Pakistan. Patients with DFUs below the malleoli were included from 1st January to 31st December 2020. Data were extracted using the Health Management System. Osteomyelitis was diagnosed and managed through standardised methods. The primary endpoint was wound healing, with or without amputation, over a 1\u2010year follow\u2010up period. Amongst 1901 patients with DFUs, 1478 (77.8%) had infected DFUs and 594 (40.2%) had diabetic foot osteomyelitis (DFO). The final analysis included 300 patients, divided into \u2018no amputation\u2019 (137, 45.6%), \u2018minor amputation\u2019 (134, 44.6%) and \u2018major amputation\u2019 (29, 9.6%) groups. Osteomyelitis distribution significantly influenced amputation patterns, particularly in the forefoot, which was involved in 73.7% of \u2018no amputation\u2019, 97.7% of \u2018minor amputation\u2019 and 58.6% of \u2018major amputation\u2019 cases. The 1st toe, 1st metatarsophalangeal joint and 5th toe were major contributors to forefoot amputations. This study signifies that DFO is quite prevalent in DFUs with forefoot osteomyelitis being the most common site. Moreover, the majority of DFO cases, require LEA including both minor and major amputations. These findings highlight the imperative for clinicians to adopt an early, multidisciplinary approach in the management of DFUs and hence DFO, aiming to prevent the onset of DFO and subsequent amputations.<\/jats:p>","DOI":"10.1111\/iwj.70084","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:15:37Z","timestamp":1746144937000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Outcome of diabetic foot ulcers at a Tertiary Care Foot Centre in Pakistan"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1592-0980","authenticated-orcid":false,"given":"Zahid","family":"Miyan","sequence":"first","affiliation":[{"name":"Department of Medicine Baqai Medical University  Karachi Pakistan"},{"name":"Diabetic Foot Department Baqai Institute of Diabetology and Endocrinology  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arwa","family":"Hatim","sequence":"additional","affiliation":[{"name":"Diabetologist Baqai Institute of Diabetology and Endocrinology, SMCHS  Karachi Pakistan"},{"name":"Diabetology and Endocrinology Saylani Welfare Trust  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saniya","family":"Khakwani","sequence":"additional","affiliation":[{"name":"Internal Medicine Trainee Basildon University Hospital  Basildon UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Abdul Basit","sequence":"additional","affiliation":[{"name":"Epidemiology and Public Health London School of Hygiene &amp; Tropical Medicine  London UK"},{"name":"Department of Acute Medicine &amp; Same Day Emergency Care Whipps Cross University Hospital Barts Health NHS Trust  London UK"},{"name":"Executive Board Member Health Promotion Foundation  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010006\u20100491\u20101"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2021.01.017"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1017201"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10061237"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.endien.2017.03.003"},{"key":"e_1_2_9_7_1","volume-title":"Diabetic Foot Infection and Lower Extremity Amputations: Recent Trends, Outcomes and Prognostic Factors","author":"Vuorlaakso M.","year":"2022"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13095"},{"key":"e_1_2_9_9_1","volume-title":"Diabetes in America","author":"Boyko EJ","year":"2018"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.12701\/jyms.2023.00731"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.08.244"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/10711007221088552"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100712467436"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3276"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.1.84"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2699"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.13342"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S181198"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0216701"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.47391\/jpma.06\u2010932"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734620986695"},{"issue":"4","key":"e_1_2_9_22_1","first-page":"17","article-title":"Diabetic foot osteomyelitis treatment: an audit of success rates in differing circumstances","volume":"22","author":"Bond H","year":"2019","journal-title":"Diabetic Foot J"},{"key":"e_1_2_9_23_1","unstructured":"\u00d6rneholmH EdmondsM.Plantar forefoot ulcer heel ulcer and minor amputation. 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