{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:42:42Z","timestamp":1787067762002,"version":"build-2736575974"},"reference-count":82,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Diabetic foot osteomyelitis (DFO) is a severe complication of diabetes mellitus and a leading cause of non-traumatic lower extremity amputation. Treatment remains clinically challenging with high recurrence rates despite standard antibiotic therapy and surgical debridement. This narrative review synthesizes current evidence on novel operative and nonoperative therapies for DFO, focusing on emerging biomaterials, local antibiotic delivery systems, innovative surgical techniques, and adjunctive topical agents. Studies examining bioabsorbable and nonabsorbable antibiotic carriers, such as calcium sulfate beads, collagen sponges, and bioactive glass, demonstrate promising infection resolution rates and a potential to reduce the surgical burden, though most are limited by small cohorts and observational designs. Similarly, alternative surgical approaches (i.e., cancelloplasty, conservative bone excision, and tibial cortex distraction) have shown early success in limb preservation. Nonoperative strategies, including adjunct antimicrobials, antimicrobial peptides, and topical oxygen, offer additional options, particularly for patients unfit for surgery. While initial outcomes are encouraging, the supporting evidence is heterogeneous and primarily limited to case series and small, noncomparative trials. Overall, these novel therapies show potential as adjuncts to established DFO management, but further prospective research is indicated to define their long-term efficacy, safety, and role in clinical practice.<\/jats:p>","DOI":"10.3390\/microorganisms13071639","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T10:26:53Z","timestamp":1752229613000},"page":"1639","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Novel Treatments for Diabetic Foot Osteomyelitis: A Narrative Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4237-1718","authenticated-orcid":false,"given":"Crystal","family":"Jing","sequence":"first","affiliation":[{"name":"School of Medicine, Duke University Health System, Duke University, 40 Duke Medicine Circle, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7703-9400","authenticated-orcid":false,"given":"Julia E.","family":"Ralph","sequence":"additional","affiliation":[{"name":"School of Medicine, Duke University Health System, Duke University, 40 Duke Medicine Circle, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Lim","sequence":"additional","affiliation":[{"name":"School of Medicine, Duke University Health System, Duke University, 40 Duke Medicine Circle, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson M.","family":"Cathey","sequence":"additional","affiliation":[{"name":"School of Medicine, Duke University Health System, Duke University, 40 Duke Medicine Circle, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4456-9445","authenticated-orcid":false,"given":"Conor N.","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Health System, Duke University, 2301 Erwin Road, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-3826","authenticated-orcid":false,"given":"Albert T.","family":"Anastasio","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Health System, Duke University, 2301 Erwin Road, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1001\/jama.2023.10578","article-title":"Diabetic Foot Ulcers: A Review","volume":"330","author":"Armstrong","year":"2023","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"100020","DOI":"10.1016\/j.celbio.2025.100020","article-title":"Hyperthermia-Enhanced Immunoregulation Hydrogel for Oxygenation and ROS Neutralization in Diabetic Foot Ulcers","volume":"1","author":"Qi","year":"2025","journal-title":"Cell Biomater."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1086\/511036","article-title":"Validation of the Infectious Diseases Society of America\u2019s Diabetic Foot Infection Classification System","volume":"44","author":"Lavery","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1111\/dme.13537","article-title":"Prognosis of the Infected Diabetic Foot Ulcer: A 12-Month Prospective Observational Study","volume":"35","author":"Ndosi","year":"2018","journal-title":"Diabet. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.2337\/dc06-0926","article-title":"Mortality and Hospitalization in Patients after Amputation: A Comparison between Patients with and without Diabetes","volume":"29","author":"Schofield","year":"2006","journal-title":"Diabetes Care"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1002\/dmrr.2699","article-title":"IWGDF Guidance on the Diagnosis and Management of Foot Infections in Persons with Diabetes","volume":"32","author":"Lipsky","year":"2015","journal-title":"Diabetes\/Metab. Res. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Lipsky, B.A., and U\u00e7kay, \u0130. (2021). Treating Diabetic Foot Osteomyelitis: A Practical State-of-the-Art Update. Medicina, 57.","DOI":"10.3390\/medicina57040339"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.jinf.2017.06.008","article-title":"Enterococci in Orthopaedic Infections: Who Is at Risk Getting Infected?","volume":"75","author":"Pires","year":"2017","journal-title":"J. Infect."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"73","DOI":"10.7150\/jbji.17171","article-title":"Which Orthopaedic Patients Are Infected with Gram-Negative Non-Fermenting Rods?","volume":"2","author":"Jamei","year":"2017","journal-title":"J. Bone Jt. Infect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1177\/1534734614550311","article-title":"Do Diabetic Foot Infections with Methicillin-Resistant Staphylococcus aureus Differ from Those with Other Pathogens?","volume":"13","author":"Zenelaj","year":"2014","journal-title":"Int. J. Low. Extrem. Wounds"},{"key":"ref_11","first-page":"26","article-title":"Diabetic Foot Infections: A Comprehensive Overview","volume":"23","author":"Pitocco","year":"2019","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1080\/14656566.2017.1316375","article-title":"Treatment Options for Diabetic Foot Osteomyelitis","volume":"18","author":"Senneville","year":"2017","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1080\/14787210.2016.1214072","article-title":"Optimising the Quality and Outcomes of Treatments for Diabetic Foot Infections","volume":"14","author":"Robineau","year":"2016","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1002\/dmrr.2247","article-title":"A Systematic Review of the Effectiveness of Interventions in the Management of Infection in the Diabetic Foot","volume":"28","author":"Peters","year":"2012","journal-title":"Diabetes\/Metab. Res. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1053\/j.jfas.2011.10.012","article-title":"Prognostic Difference Between Soft Tissue Abscess and Osteomyelitis of the Foot in Patients with Diabetes: Data from a Consecutive Series of 452 Hospitalized Patients","volume":"51","author":"Faglia","year":"2012","journal-title":"J. Foot Ankle Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1177\/230949900201000110","article-title":"The Treatment of Chronic Osteomyelitis with a Biodegradable Antibiotic-Impregnated Implant","volume":"10","author":"Gitelis","year":"2002","journal-title":"J. Orthop. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1002\/jor.20815","article-title":"Controlled Release of Vancomycin from Thin Sol-Gel Films on Implant Surfaces Successfully Controls Osteomyelitis","volume":"27","author":"Adams","year":"2009","journal-title":"J. Orthop. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1016\/S0142-9612(02)00614-2","article-title":"Residual Gentamicin-Release from Antibiotic-Loaded Polymethylmethacrylate Beads after 5 Years of Implantation","volume":"24","author":"Neut","year":"2003","journal-title":"Biomaterials"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1093\/jac\/47.6.885","article-title":"Biomaterial-Associated Infection of Gentamicin-Loaded PMMA Beads in Orthopaedic Revision Surgery","volume":"47","author":"Neut","year":"2001","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"486","DOI":"10.3113\/FAI.2009.0486","article-title":"Outcome of Transmetatarsal Amputations in Diabetics Using Antibiotic Beads","volume":"30","author":"Krause","year":"2009","journal-title":"Foot Ankle Int."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1097\/01.ASW.0000407647.12832.6c","article-title":"Managing Lower-Extremity Osteomyelitis Locally with Surgical Debridement and Synthetic Calcium Sulfate Antibiotic Tablets","volume":"24","author":"Gauland","year":"2011","journal-title":"Adv. Ski. Wound Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e13246","DOI":"10.1111\/wrr.13246","article-title":"The Infected Diabetic Foot: Risk Factors for Re-Infection after Treatment for Diabetic Foot Osteomyelitis","volume":"33","author":"Lavery","year":"2025","journal-title":"Wound Repair Regen."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1186\/s12891-019-2635-8","article-title":"Infected Bone Resection plus Adjuvant Antibiotic-Impregnated Calcium Sulfate versus Infected Bone Resection Alone in the Treatment of Diabetic Forefoot Osteomyelitis","volume":"20","author":"Qin","year":"2019","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.actbio.2025.01.055","article-title":"Revisiting the Physical and Chemical Nature of the Mineral Component of Bone","volume":"196","author":"Shah","year":"2025","journal-title":"Acta Biomater."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.foot.2017.11.011","article-title":"Single Stage Treatment of Diabetic Calcaneal Osteomyelitis with an Absorbable Gentamicin-Loaded Calcium Sulphate\/Hydroxyapatite Biocomposite: The Silo Technique","volume":"34","author":"Drampalos","year":"2018","journal-title":"Foot"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.foot.2019.01.005","article-title":"Adjuvant Antibiotic Loaded Bio Composite in the Management of Diabetic Foot Osteomyelitis\u2014A Multicentre Study","volume":"39","author":"Niazi","year":"2019","journal-title":"Foot"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"565","DOI":"10.9738\/INTSURG-D-13-00171.1","article-title":"The Use of Collatamp G, Local Gentamicin-Collagen Sponge, in Reducing Wound Infection","volume":"99","author":"Chia","year":"2014","journal-title":"Int. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1002\/jps.10098","article-title":"Modeling of Drug Release from Collagen Matrices","volume":"91","author":"Radu","year":"2002","journal-title":"J. Pharm. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1016\/j.addr.2003.08.007","article-title":"Collagen as a Carrier for On-Site Delivery of Antibacterial Drugs","volume":"55","author":"Ruszczak","year":"2003","journal-title":"Adv. Drug Deliv. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"283","DOI":"10.5114\/aoms.2014.42580","article-title":"Application of Gentamicin-Collagen Sponge Shortened Wound Healing Time after Minor Amputations in Diabetic Patients\u2013A Prospective, Randomised Trial","volume":"10","author":"Varga","year":"2014","journal-title":"Arch. Med. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1002\/jbm.820050611","article-title":"Bonding Mechanisms at the Interface of Ceramic Prosthetic Materials","volume":"5","author":"Hench","year":"1971","journal-title":"J. Biomed. Mater. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1053\/j.jfas.2020.06.029","article-title":"Efficacy and Safety of Bioactive Glass S53P4 as a Treatment for Diabetic Foot Osteomyelitis","volume":"60","author":"Mondello","year":"2021","journal-title":"J. Foot Ankle Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1080\/23744235.2019.1695059","article-title":"The Role of Bioactive Glass in the Management of Chronic Osteomyelitis: A Systematic Review of Literature and Current Evidence","volume":"52","author":"Tanwar","year":"2020","journal-title":"Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1177\/1534734620926003","article-title":"Pilot Experience on the Use of S53P4 Bioactive Glass in the Surgical Management of Diabetic Foot Osteomyelitis","volume":"21","author":"Iacopi","year":"2022","journal-title":"Int. J. Low Extrem. Wounds"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Kastrin, M., Urban\u010di\u010d Rovan, V., and Frange\u017e, I. (2021). Possible Advantages of S53P4 Bioactive Glass in the Treatment of Septic Osteoarthritis of the First Metatarsophalangeal Joint in the Diabetic Foot. J. Clin. Med., 10.","DOI":"10.3390\/jcm10061208"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1097\/00005131-200210000-00002","article-title":"The Use of an Antibiotic-Impregnated, Osteoconductive, Bioabsorbable Bone Substitute in the Treatment of Infected Long Bone Defects: Early Results of a Prospective Trial","volume":"16","author":"McKee","year":"2002","journal-title":"J. Orthop. Trauma"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1002\/jor.20214","article-title":"High Concentration and Bioactivity of Vancomycin and Aztreonam Eluted from Simplex Cement Spacers in Two-Stage Revision of Infected Hip Implants: A Study of 46 Patients at an Average Follow-up of 107 Days","volume":"24","author":"Hsieh","year":"2006","journal-title":"J. Orthop. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3113\/FAI.2012.0213","article-title":"Antibiotic Impregnated Cement Spacer for Salvage of Diabetic Osteomyelitis","volume":"33","author":"Melamed","year":"2012","journal-title":"Foot Ankle Int."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Khury, F., Karkabi, I., Mazzawi, E., Norman, D., Melamed, E.A., and Peled, E. (2024). Revisiting Antibiotic-Impregnated Cement Spacer for Diabetic Osteomyelitis of the Foot. Antibiotics, 13.","DOI":"10.3390\/antibiotics13121153"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1177\/1938640020975885","article-title":"Cancelloplasty for Treatment of Osteomyelitis of the Calcaneus: A Novel Technique and Case Report","volume":"14","author":"Huchital","year":"2021","journal-title":"Foot Ankle Spec."},{"key":"ref_41","first-page":"86","article-title":"Conservative Surgery for Chronic Diabetic Foot Osteomyelitis: Procedures and Recommendations","volume":"16","year":"2020","journal-title":"J. Clin. Orthop. Trauma"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1080\/14787210.2018.1417037","article-title":"Modern Management of Diabetic Foot Osteomyelitis. The When, How and Why of Conservative Approaches","volume":"16","author":"Lipsky","year":"2018","journal-title":"Expert. Rev. Anti-Infect. Ther."},{"key":"ref_43","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_44","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.ejvs.2006.10.008","article-title":"A Novel Approach to the Management of the Diabetic Foot: Metatarsal Excision in the Treatment of Osteomyelitis","volume":"33","author":"Freeman","year":"2007","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1177\/10711007231194046","article-title":"Comparative Efficacy of Conservative Surgery vs Minor Amputation for Diabetic Foot Osteomyelitis","volume":"44","author":"Waibel","year":"2023","journal-title":"Foot Ankle Int."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1177\/10711007231178530","article-title":"Percutaneous Partial Bone Excision in the Management of Diabetic Toe Osteomyelitis","volume":"44","author":"Moosa","year":"2023","journal-title":"Foot Ankle Int."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/00003086-198901000-00038","article-title":"The Tension-Stress Effect on the Genesis and Growth of Tissues. Part 1. The influence of stability of fixation and soft-tissue preservation","volume":"238","author":"Ilizarov","year":"1989","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"0300060520954697","DOI":"10.1177\/0300060520954697","article-title":"Tibial Cortex Transverse Distraction in Treating Diabetic Foot Ulcers: What Are We Concerned About?","volume":"48","author":"Fan","year":"2020","journal-title":"J. Int. Med. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3163","DOI":"10.1007\/s00167-016-4236-5","article-title":"Morphological Classification of the Femoral Trochlear Groove Based on a Quantitative Measurement of Computed Tomographic Models","volume":"25","author":"Chen","year":"2017","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1111\/iwj.13916","article-title":"An Novel and Alternative Treatment Method for Large Heel Ulceration in Diabetic Patients: Proximal Tibial Cortex Transverse Distraction","volume":"20","author":"Xu","year":"2023","journal-title":"Int. Wound J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1177\/1534734618757532","article-title":"Local Antibiotic Delivery Systems: Current and Future Applications for Diabetic Foot Infections","volume":"17","author":"Markakis","year":"2018","journal-title":"Int. J. Low Extrem. Wounds"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e1916003","DOI":"10.1001\/jamanetworkopen.2019.16003","article-title":"Adjunctive Rifampin Therapy for Diabetic Foot Osteomyelitis in the Veterans Health Administration","volume":"2","author":"Wilson","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"637","DOI":"10.2337\/dc07-1744","article-title":"Outcome of Diabetic Foot Osteomyelitis Treated Nonsurgically: A Retrospective Cohort Study","volume":"31","author":"Senneville","year":"2008","journal-title":"Diabetes Care"},{"key":"ref_54","unstructured":"Office of Research & Development (2025). CSP #2001\u2013Investigation of Rifampin to Reduce Pedal Amputations for Osteomyelitis in Diabetics (VA Intrepid)."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Turza\u0144ska, K., Adesanya, O., Rajagopal, A., Pryce, M.T., and Fitzgerald Hughes, D. (2023). Improving the Management and Treatment of Diabetic Foot Infection: Challenges and Research Opportunities. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24043913"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"3818","DOI":"10.1096\/fj.13-227942","article-title":"Sensitization of Gram-Negative Bacteria by Targeting the Membrane Potential","volume":"27","author":"Goldberg","year":"2013","journal-title":"FASEB J."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Vargas, A., Garcia, G., Rivara, K., Woodburn, K., Clemens, L.E., and Simon, S.I. (2023). A Designed Host Defense Peptide for the Topical Treatment of MRSA-Infected Diabetic Wounds. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24032143"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e00520-19","DOI":"10.1128\/AAC.00520-19","article-title":"Cholic Acid-Peptide Conjugates as Potent Antimicrobials against Interkingdom Polymicrobial Biofilms","volume":"63","author":"Gupta","year":"2019","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e0294287","DOI":"10.1371\/journal.pone.0294287","article-title":"Synergistic Effect of Two Antimicrobial Peptides, BP203 and MAP-0403 J-2 with Conventional Antibiotics against Colistin-Resistant Escherichia coli and Klebsiella pneumoniae Clinical Isolates","volume":"18","author":"Chatupheeraphat","year":"2023","journal-title":"PLoS ONE"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e2401793","DOI":"10.1002\/advs.202401793","article-title":"Dual-Mechanism Peptide SR25 Has Broad Antimicrobial Activity and Potential Application for Healing Bacteria-Infected Diabetic Wounds","volume":"11","author":"Luo","year":"2024","journal-title":"Adv. Sci."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e1539","DOI":"10.1093\/cid\/ciaa1758","article-title":"Three Weeks Versus Six Weeks of Antibiotic Therapy for Diabetic Foot Osteomyelitis: A Prospective, Randomized, Noninferiority Pilot Trial","volume":"73","author":"Gariani","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"ciad527","DOI":"10.1093\/cid\/ciad527","article-title":"IWGDF\/IDSA Guidelines on the Diagnosis and Treatment of Diabetes-Related Foot Infections (IWGDF\/IDSA 2023)","volume":"40","author":"Senneville","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"394","DOI":"10.12968\/jowc.2014.23.8.394","article-title":"A Novel Approach to the Treatment of Diabetic Foot Abscesses\u2013a Case Series","volume":"23","author":"Cahn","year":"2014","journal-title":"J. Wound Care"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1111\/j.1440-1681.2008.04934.x","article-title":"Topical Oxygen Therapy Induces Vascular Endothelial Growth Factor Expression and Improves Closure of Clinically Presented Chronic Wounds","volume":"35","author":"Gordillo","year":"2008","journal-title":"Clin. Exp. Pharmacol. Physiol."},{"key":"ref_65","first-page":"24","article-title":"Topical Wound Oxygen Therapy in the Treatment of Severe Diabetic Foot Ulcers: A Prospective Controlled Study","volume":"56","author":"Blackman","year":"2010","journal-title":"Ostomy Wound Manag."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.ijid.2015.09.023","article-title":"Diabetic Foot Infections: What Have We Learned in the Last 30 Years?","volume":"40","author":"Lew","year":"2015","journal-title":"Int. J. Infect. Dis."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/S0928-4680(02)00079-2","article-title":"Topical Oxygen as an Adjunct to Wound Healing: A Clinical Case Series","volume":"9","author":"Kalliainen","year":"2003","journal-title":"Pathophysiology"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e3730","DOI":"10.1002\/dmrr.3730","article-title":"Interventions in the Management of Diabetes-Related Foot Infections: A Systematic Review","volume":"40","author":"Peters","year":"2024","journal-title":"Diabetes\/Metab. Res. Rev."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e3534","DOI":"10.1002\/dmrr.3534","article-title":"Conservative Surgical Treatment for Metatarsal Osteomyelitis in Diabetic Foot: Experience of Two French Centres","volume":"38","author":"Nguyen","year":"2022","journal-title":"Diabetes\/Metab. Res. Rev."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1080\/14737167.2019.1567337","article-title":"Current Health and Economic Burden of Chronic Diabetic Osteomyelitis","volume":"19","author":"Geraghty","year":"2019","journal-title":"Expert. Rev. Pharmacoecon. Outcomes Res."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1615\/JLongTermEffMedImplants.v17.i3.10","article-title":"Cost of Antibiotic Beads Is Justified: A Study of Open Fracture Wounds and Chronic Osteomyelitis","volume":"17","author":"Wright","year":"2007","journal-title":"J. Long-Term Eff. Med. Implant."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1116711","DOI":"10.3389\/fmed.2023.1116711","article-title":"Cost-Effectiveness of a Bone Substitute Delivering Gentamicin in the Treatment of Chronic Osteomyelitis of Long Bones: Protocol for the CONVICTION Randomized Multicenter Study","volume":"10","author":"Serrier","year":"2023","journal-title":"Front. Med."},{"key":"ref_73","unstructured":"(2025, July 04). Bioactive Glass Powder, S53P4, \u226598%, 50\u2013250 \u039cm Particle Size|Sigma-Aldrich. Available online: https:\/\/www.sigmaaldrich.com\/US\/en\/product\/aldrich\/915580?srsltid=AfmBOopGR5zzfN0jhLgVvTDWBGx3kwOlzNPC7a_wgEq0tgvqWlBHbSFu."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Geurts, J., van Vugt, T., Thijssen, E., and Arts, J.J. (2019). Cost-Effectiveness Study of One-Stage Treatment of Chronic Osteomyelitis with Bioactive Glass S53P4. Materials, 12.","DOI":"10.3390\/ma12193209"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1111\/iwj.13468","article-title":"An Economic Evaluation Examining the Cost-effectiveness of Continuous Diffusion of Oxygen Therapy for Individuals with Diabetic Foot Ulcers","volume":"17","author":"Chan","year":"2020","journal-title":"Int. Wound J."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2552","DOI":"10.1111\/dom.16254","article-title":"Efficacy and Safety of a Bio-Absorbable Antibiotic Delivery in Calcium Sulphate Granules for the Treatment of Osteomyelitis in Patients with Diabetic Foot: A Randomized, Double Blinded, Controlled Clinical Study the BIG D-FOOT Study","volume":"27","author":"Monami","year":"2025","journal-title":"Diabetes Obes. Metab."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/QCO.0000000000000530","article-title":"Principles and Practice of Antibiotic Stewardship in the Management of Diabetic Foot Infections","volume":"32","author":"Berli","year":"2019","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.diabres.2015.09.016","article-title":"High Burden of Diabetic Foot Infections in the Top End of Australia: An Emerging Health Crisis (DEFINE Study)","volume":"110","author":"Commons","year":"2015","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1177\/027298902400448902","article-title":"Estimating Utility Values for Health States of Type 2 Diabetic Patients Using the EQ-5D (UKPDS 62)","volume":"22","author":"Clarke","year":"2002","journal-title":"Med. Decis. Mak."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Wang, J.-S., and Dunne, N. (2008). Bone cement fixation: Acrylic cements. Joint Replacement Technology, Woodhead Publishing Limited.","DOI":"10.1533\/9781845694807.2.212"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e35597","DOI":"10.1002\/jbm.b.35597","article-title":"Safety and Efficacy of S53P4 Bioactive Glass in Osteomyelitis Management: A Systematic Review and Meta-Analysis","volume":"113","author":"Nguyen","year":"2025","journal-title":"J. Biomed. Mater. Res. B Appl. Biomater."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1007\/s10096-023-04737-z","article-title":"Clinical Outcomes and Complications of S53P4 Bioactive Glass in Chronic Osteomyelitis and Septic Non-Unions: A Retrospective Single-Center Study","volume":"43","author":"Gatti","year":"2024","journal-title":"Eur. J. Clin. Microbiol. Infect. 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