{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:51:16Z","timestamp":1753883476716,"version":"3.41.2"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T00:00:00Z","timestamp":1646179200000},"content-version":"vor","delay-in-days":60,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T00:00:00Z","timestamp":1646179200000},"content-version":"vor","delay-in-days":60,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001792","name":"James Cook University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001792","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1117061"],"award-info":[{"award-number":["1117061"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Journal of Foot and Ankle Research"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is a lack of high quality evidence to guide the optimal management of diabetes\u2010related foot infection, particularly in cases of severe diabetes\u2010related foot infection and diabetes\u2010related foot osteomyelitis. This study examined the opinions of surgeons about the preferred management of severe diabetes\u2010related foot infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Vascular and orthopaedic surgeons in Australia and New Zealand were invited to complete an online survey via email. The survey included multi\u2010choice and open\u2010ended questions on clinical management of diabetes\u2010related foot infection. Responses of vascular surgeons and orthopaedic surgeons were compared using non\u2010parametric statistical tests. Open\u2010text responses were examined using inductive content analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>29 vascular and 20 orthopaedic surgeons completed the survey. One\u2010third (28.6%) used best\u2010practice guidelines to assist in decisions about foot infection management. Areas for guideline improvement identified included more specific advice regarding the indications for available treatments, more recommendations about non\u2010surgical patient management and advice on how management can be varied in regions with limited health service resource. The probe\u2010to\u2010bone test and magnetic resonance imaging were the preferred methods of diagnosing osteomyelitis. Approximately half (51.2%) of respondents indicated piperacillin combined with tazobactam as the preferred antibiotic choice for empirical treatment of severe diabetes\u2010related foot infection. Negative pressure wound therapy was the most common way of managing a wound following debridement. All vascular surgeons (100%) made revascularisation decisions based on the severity of ischemia while most orthopaedic surgeons (66.7%) were likely to refer to vascular surgeons to make revascularisation decisions. Vascular surgeons preferred using wound swabs while orthopaedic surgeons favoured tissue or bone biopsies to determine the choice of antibiotic. Respondents perceived a moderate variation in management decisions between specialists and supported the need for randomised controlled trials to test different management pathways.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most vascular and orthopaedic surgeons do not use best\u2010practice guidelines to assist in decisions about management of diabetes\u2010related foot infection. Vascular and orthopaedic surgeons appear to have different preferences for wound sampling to determine choice of antibiotic. There is a need for higher quality evidence to clarify best practice for managing diabetes\u2010related foot infection.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13047-022-00523-w","type":"journal-article","created":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T02:02:39Z","timestamp":1646186559000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Opinions about the most appropriate surgical management of diabetes\u2010related foot infection: a cross\u2010sectional survey"],"prefix":"10.1002","volume":"15","author":[{"given":"Leonard","family":"Seng","sequence":"first","affiliation":[{"name":"Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University 4811 Townsville Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Drovandi","sequence":"additional","affiliation":[{"name":"Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University 4811 Townsville Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malindu E","family":"Fernando","sequence":"additional","affiliation":[{"name":"Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University 4811 Townsville Queensland Australia"},{"name":"Ulcer and wound Healing consortium (UHEAL) Australian Institute of Tropical Health and Medicine James Cook University Townsville Queensland Australia"},{"name":"Faculty of Health and Medicine School of Health Sciences University of Newcastle Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Golledge","sequence":"additional","affiliation":[{"name":"Department of Vascular and Endovascular Surgery Townsville University Hospital Townsville Queensland Australia"},{"name":"Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University 4811 Townsville Queensland Australia"},{"name":"Ulcer and wound Healing consortium (UHEAL) Australian Institute of Tropical Health and Medicine James Cook University Townsville Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047\u2010021\u201000447\u2010x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/511036"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3280"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S181198"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13\u20101526"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10061237"},{"issue":"9","key":"e_1_2_12_8_1","first-page":"Cd009061","article-title":"Systemic antibiotics for treating diabetic foot infections","volume":"2015","author":"Selva Olid A","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2015.09.023"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047\u2010018\u20100256\u20103"},{"key":"e_1_2_12_11_1","first-page":"240","volume-title":"Quality Standards for Diabetes Care Toolkit","author":"Ministry of Health","year":"2014"},{"key":"e_1_2_12_12_1","unstructured":"Diabetic Foot Australia.Australian and International Guidelines on Diabetic Foot Disease2016 03 August 2021[cited 2021 03 August 2021]:[32p.]. Available from:https:\/\/diabeticfootaustralia.org\/wp\u2010content\/uploads\/DFA\u2010Guides\u2010you\u2010through\u2010guidelines.pdf."},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u2010475X.2010.00571.x"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31820023dc"},{"key":"e_1_2_12_15_1","unstructured":"Diabetes Feet Australia.Developing new Australian Guidelines for diabetes\u2010related foot disease2021[Available from:https:\/\/www.diabetesfeetaustralia.org\/new\u2010guidelines\/."},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17\u20100532"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw445"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.2.125"},{"issue":"7","key":"e_1_2_12_19_1","first-page":"CD010471","article-title":"Dressings for treating foot ulcers in people with diabetes: an overview of systematic reviews","volume":"2015","author":"Wu L","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3283"}],"container-title":["Journal of Foot and Ankle Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13047-022-00523-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13047-022-00523-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13047-022-00523-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1186\/s13047-022-00523-w","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T05:09:55Z","timestamp":1706850595000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1186\/s13047-022-00523-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1186\/s13047-022-00523-w"],"URL":"https:\/\/doi.org\/10.1186\/s13047-022-00523-w","archive":["Portico"],"relation":{},"ISSN":["1757-1146","1757-1146"],"issn-type":[{"type":"print","value":"1757-1146"},{"type":"electronic","value":"1757-1146"}],"subject":[],"published":{"date-parts":[[2022,1]]},"assertion":[{"value":"30 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 February 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 March 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study received an ethics waiver from the Townsville Hospital and Health Service Human Research Ethics Committee (LNR\/2020\/QTHS\/69539). Ethics waivers are available for clinical audits and quality improvement or assurance research activities that are considered as being of low or negligible risk. Participants imply their consent by online submission of the survey.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"18"}}