{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:43:20Z","timestamp":1760147000785,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Aim: To compare the healing time in patients with diabetic foot osteomyelitis according to the presence or absence of clinical signs of infection, variation of blood parameters, the presence of different radiological signs, and the treatment received for the management of osteomyelitis. Methods: A prospective observational study was carried out in a specialised Diabetic Foot Unit between November 2014 and November 2018. A total of 116 patients with osteomyelitis were included in the study (treated by either a surgical or medical approach). During the baseline visit, we assessed the diagnosis of osteomyelitis, demographic characteristics and medical history, vascular and neurological examination, clinical signs of infection, increased blood parameters, radiological signs of osteomyelitis, and the treatment to manage osteomyelitis. We analysed the association between the presence of clinical signs of infection, variation of blood parameters, presence of radiological signs, and treatment received for management of osteomyelitis with the healing time. Results: The mean time to ulcer healing was 15.8 \u00b1 9.7 weeks. Concerning healing times, we did not find an association with the presence of clinical signs of infection or with the increase in blood parameters, except in the case of eosinophils, which with higher values appear to increase the healing time (U = 66, z = \u22122.880, p = 0.004). Likewise, no relationship has been found between healing time and the appearance of the different radiological signs of osteomyelitis, nor depending on the treatment administered for the management of osteomyelitis. Conclusion: High levels of eosinophils are associated with a longer healing time of diabetic foot ulcers complicated with osteomyelitis, finding no other factors related to increased healing time.<\/jats:p>","DOI":"10.3390\/jcm12010345","type":"journal-article","created":{"date-parts":[[2023,1,2]],"date-time":"2023-01-02T03:00:59Z","timestamp":1672628459000},"page":"345","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Variables That Could Influence Healing Time in Patients with Diabetic Foot Osteomyelitis"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5650-7351","authenticated-orcid":false,"given":"Aroa","family":"Tard\u00e1guila-Garc\u00eda","sequence":"first","affiliation":[{"name":"Diabetic Foot Unit, Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4674-3822","authenticated-orcid":false,"given":"Francisco Javier","family":"\u00c1lvaro-Afonso","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7349-7378","authenticated-orcid":false,"given":"Marta","family":"Garc\u00eda-Madrid","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7342-059X","authenticated-orcid":false,"given":"Mateo","family":"L\u00f3pez-Moral","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Sanz-Corbal\u00e1n","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6110-0265","authenticated-orcid":false,"given":"Jos\u00e9 Luis","family":"L\u00e1zaro-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, Cl\u00ednica Universitaria de Podolog\u00eda, Facultad de Enfermer\u00eda, Fisioterapia y Podolog\u00eda, Universidad Complutense de Madrid, 28040 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,1]]},"reference":[{"key":"ref_1","first-page":"100","article-title":"Diagnostic and therapeutic update on diabetic foot osteomyelitis","volume":"64","year":"2017","journal-title":"Endocrinol. Diabetes Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"947","DOI":"10.2147\/DMSO.S181198","article-title":"Optimal management of diabetic foot osteomyelitis: Challenges and solutions","volume":"12","year":"2019","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Tardaguila-Garcia, A., Sanz-Corbalan, I., Garcia-Alamino, J.M., Ahluwalia, R., Uccioli, L., and Lazaro-Martinez, J.L. (2021). Medical Versus Surgical Treatment for the Management of Diabetic Foot Osteomyelitis: A Systematic Review. J. Clin. Med., 10.","DOI":"10.3390\/jcm10061237"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Tardaguila-Garcia, A., Garcia-Alvarez, Y., Garcia-Morales, E., Lopez-Moral, M., Sanz-Corbalan, I., and Lazaro-Martinez, J.L. (2021). Long-Term Complications after Surgical or Medical Treatment of Predominantly Forefoot Diabetic Foot Osteomyelitis: 1 Year Follow. J. Clin. Med., 10.","DOI":"10.3390\/jcm10091943"},{"key":"ref_5","first-page":"1","article-title":"Are Digital Arthroplasty and Arthrodesis Useful and Safe Surgical Techniques for the Management of Patients with Diabetic Foot?","volume":"35","year":"2022","journal-title":"Adv. Skin Wound Care."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Tardaguila-Garcia, A., Garcia Alvarez, Y., Garcia-Morales, E., Alvaro-Afonso, F.J., Sanz-Corbalan, I., and Lazaro-Martinez, J.L. (2020). Utility of Blood Parameters to Detect Complications during Long-Term Follow-Up in Patients with Diabetic Foot Osteomyelitis. J. Clin. Med., 9.","DOI":"10.3390\/jcm9113768"},{"key":"ref_7","first-page":"1","article-title":"Could X-ray Predict Long-term Complications in Patients with Diabetic Foot Osteomyelitis?","volume":"35","year":"2022","journal-title":"Adv. Skin Wound Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/j.1464-5491.2010.03150.x","article-title":"Diagnosing diabetic foot osteomyelitis: Is the combination of probe-to-bone test and plain radiography sufficient for high-risk inpatients?","volume":"28","author":"Lipsky","year":"2011","journal-title":"Diabet Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e3280","DOI":"10.1002\/dmrr.3280","article-title":"Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update)","volume":"36","author":"Lipsky","year":"2020","journal-title":"Diabetes\/Metab. Res. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1097\/01.ASW.0000734376.32571.20","article-title":"Diagnostic Accuracy of Bone Culture Versus Biopsy in Diabetic Foot Osteomyelitis","volume":"34","year":"2021","journal-title":"Adv. Skin Wound Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e3276","DOI":"10.1002\/dmrr.3276","article-title":"Guidelines on diagnosis, prognosis, and management of peripheral artery disease in patients with foot ulcers and diabetes (IWGDF 2019 update)","volume":"36","author":"Hinchliffe","year":"2020","journal-title":"Diabetes\/Metabolism Res. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"147","DOI":"10.2337\/diacare.22.1.147","article-title":"Transcutaneous oxygen tension and toe blood pressure as predictors for outcome of diabetic foot ulcers","volume":"22","author":"Kalani","year":"1999","journal-title":"Diabetes Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/j.jvs.2006.12.037","article-title":"Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II)","volume":"45","author":"Norgren","year":"2007","journal-title":"J. Vasc. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e3266","DOI":"10.1002\/dmrr.3266","article-title":"Practical Guidelines on the prevention and management of diabetic foot disease (IWGDF 2019 update)","volume":"36","author":"Schaper","year":"2020","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e132","DOI":"10.1093\/cid\/cis346","article-title":"2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections","volume":"54","author":"Lipsky","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"593","DOI":"10.2337\/dc13-2510","article-title":"Treating diabetic foot osteomyelitis primarily with surgery or antibiotics: Have we answered the question?","volume":"37","author":"Lipsky","year":"2014","journal-title":"Diabetes Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/1534734610361949","article-title":"Treatment of diabetic foot osteomyelitis: A surgical critique","volume":"9","year":"2010","journal-title":"Int. J. Low. Extremity Wounds"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/01.ASW.0000542527.48815.1f","article-title":"Correlation between Empirical Antibiotic Therapy and Bone Culture Results in Patients with Osteomyelitis","volume":"32","year":"2019","journal-title":"Adv. Ski. Wound Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"302","DOI":"10.2337\/dc14-1514","article-title":"Six-week versus twelve-week antibiotic therapy for nonsurgically treated diabetic foot osteomyelitis: A multicenter open-label controlled randomised study","volume":"38","author":"Tone","year":"2015","journal-title":"Diabetes Care"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e3268","DOI":"10.1002\/dmrr.3268","article-title":"Definitions and criteria for diabetic foot disease","volume":"36","author":"Bus","year":"2020","journal-title":"Diabetes\/Metabolism Res. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e3283","DOI":"10.1002\/dmrr.3283","article-title":"Guidelines on use of interventions to enhance healing of chronic foot ulcers in diabetes (IWGDF 2019 update)","volume":"36","author":"Rayman","year":"2020","journal-title":"Diabetes\/Metabolism Res. Rev."},{"key":"ref_22","first-page":"14","article-title":"World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects","volume":"81","year":"2014","journal-title":"J. Am. Coll. Dent."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"5","DOI":"10.12968\/jowc.2020.29.1.5","article-title":"Role of inflammatory markers in the healing time of diabetic foot osteomyelitis treated by surgery or antibiotics","volume":"29","year":"2020","journal-title":"J. Wound Care"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/iwj.12574","article-title":"Erythrocyte sedimentation rate and C-reactive protein to monitor treatment outcomes in diabetic foot osteomyelitis","volume":"14","author":"Jupiter","year":"2017","journal-title":"Int. Wound J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"789","DOI":"10.2337\/dc13-1526","article-title":"Antibiotics versus conservative surgery for treating diabetic foot osteomyelitis: A randomized comparative trial","volume":"37","year":"2014","journal-title":"Diabetes Care"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/345\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T17:55:37Z","timestamp":1760118937000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/345"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,1]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["jcm12010345"],"URL":"https:\/\/doi.org\/10.3390\/jcm12010345","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2023,1,1]]}}}