{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:03Z","timestamp":1783509303166,"version":"3.55.0"},"reference-count":23,"publisher":"MDPI AG","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Surgery is often required to manage acute soft-tissue or chronic bone infection of the foot and can include aggressive incision and drainage and debridement of nonviable tissue and bone to eradicate infection. Achieving a stable plantigrade foot for weightbearing can be challenging, and limb salvage is deemed successful if the patient can bear weight on the plantar aspect of the foot without further ulceration.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    A retrospective outcomes evaluation for patients who underwent forefoot surgery for diabetic foot infection in an integrated consultant-led podiatric surgery service was performed. Fifty-six patients met the inclusion criteria, and their electronic and paper records were reviewed to establish patient demographics, dates and levels of limb salvage surgery, and mortality rates.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Ninety-one procedures were performed. The mean patient age at first procedure was 60.34 years. The most commonly performed procedure was whole hallux amputation (n = 12), with a reoperation rate of 41.66%. First procedures had a total reoperation rate of 44%; 37.5% in the ipsilateral limb and 7% in the contralateral limb within 407.03 days. The mortality rate was 25%, and the average age at death was 68.43 years. Average time from first surgery to death was 2.83 years.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    This study indicates the range of procedures that can be performed by the podiatric surgery team in the event of deteriorating forefoot infection, and we acknowledge that the level of surgery influences the distribution of weightbearing forces and the risk of further ulceration. We highlight the contribution of our speciality to this patient group with good long-term results.\n                  <\/jats:p>","DOI":"10.7547\/23-085","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T10:07:07Z","timestamp":1745575627000},"source":"Crossref","is-referenced-by-count":0,"title":["Forefoot Surgery for the Management of Diabetes-Related Foot Infections"],"prefix":"10.3390","volume":"115","author":[{"given":"Robyn L.","family":"Carter-Wale","sequence":"first","affiliation":[{"name":"Department of Podiatric Surgery, Homerton University Hospital NHS Foundation Trust, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor D.","family":"Prior","sequence":"additional","affiliation":[{"name":"Department of Podiatric Surgery, Homerton University Hospital NHS Foundation Trust, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J.","family":"Coleman","sequence":"additional","affiliation":[{"name":"Department of Podiatric Surgery, Homerton University Hospital NHS Foundation Trust, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"Orthop Trauma","first-page":"416","article-title":"Diagnosis and management of the acute hot diabetic foot","volume":"32","author":"Lever CJ","year":"2018","unstructured":"Lever CJ: Diagnosis and management of the acute hot diabetic foot. Orthop Trauma 32: 416, 2018."},{"key":"B2","article-title":"Diabetic foot guide","unstructured":"National Diabetes Support Team: Diabetic foot guide. Available at: http:\/\/www.bipsolutions.com\/docstore\/pdf\/13429.pdf. Accessed June 13, 2019."},{"key":"B3","series-title":"Diabet Med","first-page":"855","article-title":"Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs","volume":"29","author":"Hex N","year":"2012","unstructured":"Hex N, Bartlett C, Wright D, et al: Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabet Med 29: 855, 2012."},{"key":"B4","article-title":"Diabetic foot problems: prevention and management","year":"2019","unstructured":"National Institute for Health and Care Excellence (NICE): Diabetic foot problems: prevention and management. NICE guideline NG19. Available at: https:\/\/www.nice.org.uk\/guidance\/ng19. Published August 26, 2015. Updated October 11, 2019."},{"key":"B5","series-title":"Diabet Foot Ankle","first-page":"18409","article-title":"Diabetic foot infections: current concept review","volume":"3","author":"Hobizal KB","year":"2012","unstructured":"Hobizal KB, Wukich DK: Diabetic foot infections: current concept review. Diabet Foot Ankle 3: 18409, 2012."},{"key":"B6","series-title":"Diabetes Res Clin Pract","first-page":"347","article-title":"Risk factors for developing osteomyelitis in patients with diabetic foot wounds","volume":"83","author":"Lavery LA","year":"2009","unstructured":"Lavery LA, Peters EJ, Armstrong DG, et al: Risk factors for developing osteomyelitis in patients with diabetic foot wounds. Diabetes Res Clin Pract 83: 347, 2009."},{"key":"B7","series-title":"JAPMA","first-page":"335","article-title":"The costs of diabetic foot: the economic case for the limb salvage team","volume":"100","author":"Driver VR","year":"2010","unstructured":"Driver VR, Fabbi M, Lavery LA, et al: The costs of diabetic foot: the economic case for the limb salvage team. JAPMA 100: 335, 2010."},{"key":"B8","series-title":"Foot Ankle Surg","first-page":"215","article-title":"Evidence based review of literature on detriments to healing of diabetic foot ulcers","volume":"23","author":"Lefrancois T","year":"2017","unstructured":"Lefrancois T, Mehta K, Sullivan V, et al: Evidence based review of literature on detriments to healing of diabetic foot ulcers. Foot Ankle Surg 23: 215, 2017."},{"key":"B9","series-title":"BMC Surg","first-page":"83","article-title":"Treatment of the diabetic foot: to amputate or not?","volume":"14","author":"Weledji EP","year":"2014","unstructured":"Weledji EP, Fokam P: Treatment of the diabetic foot: to amputate or not? BMC Surg 14: 83, 2014."},{"key":"B10","series-title":"J Foot Ankle Surg","first-page":"593","article-title":"Feasibility and effectiveness of internal pedal amputation of phalanx or metatarsal head in diabetic patients with forefoot osteomyelitis","volume":"51","author":"Faglia E","year":"2012","unstructured":"Faglia E, Clerici G, Caminiti M, et al: Feasibility and effectiveness of internal pedal amputation of phalanx or metatarsal head in diabetic patients with forefoot osteomyelitis. 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Int J Low Extrem Wounds 8: 69, 2009."},{"key":"B13","series-title":"Diabetes Care","first-page":"7","article-title":"Mortality in diabetic and non-diabetic patients after amputations performed from 1990 to 1995; a 5 year followup study","volume":"27","author":"Tentolouris N","year":"2004","unstructured":"Tentolouris N, Boulton AJM, Al-Sabbagh S, et al: Mortality in diabetic and non-diabetic patients after amputations performed from 1990 to 1995; a 5 year followup study. Diabetes Care 27: 7, 2004."},{"key":"B14","series-title":"Diabetes Care","first-page":"566","article-title":"Risk of reamputation in diabetic patients stratified by limb and level of amputation; a 10 year observation","volume":"29","author":"Izumi Y","year":"2006","unstructured":"Izumi Y, Lee S, Satterfield K, et al: Risk of reamputation in diabetic patients stratified by limb and level of amputation; a 10 year observation. Diabetes Care 29: 566, 2006."},{"key":"B15","series-title":"JAPMA","first-page":"255","article-title":"Amputation and reamputation of the diabetic foot","volume":"87","author":"Armstrong DG","year":"1997","unstructured":"Armstrong DG, Lavery LA, Harkless LB, et al: Amputation and reamputation of the diabetic foot. JAPMA 87: 255, 1997."},{"key":"B16","series-title":"J Diabetes Complications","first-page":"251","article-title":"Toe amputation: a predictor of future limb loss?","volume":"26","author":"Griffin KJ","year":"2012","unstructured":"Griffin KJ, Rashid TS, Bailey MA, et al: Toe amputation: a predictor of future limb loss? J Diabetes Complications 26: 251, 2012."},{"key":"B17","series-title":"Foot Ankle Spec","first-page":"131","article-title":"Prospective analysis of surgical bone margins after partial foot amputation in diabetic patients admitted with moderate to severe foot infections","volume":"12","author":"Schmidt BM","year":"2019","unstructured":"Schmidt BM, McHugh JB, Patel RM, et al: Prospective analysis of surgical bone margins after partial foot amputation in diabetic patients admitted with moderate to severe foot infections. 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J Foot Ankle Surg 51: 749, 2012."},{"key":"B19","series-title":"J Foot Ankle Surg","first-page":"720","article-title":"In-office distal Symes lesser toe amputation: a safe, reliable and cost effective treatment of diabetes-related tip of toe ulcers complicate by osteomyelitis","volume":"53","author":"Boffeli TJ","year":"2014","unstructured":"Boffeli TJ, Abben KW, Hyllengren SB: In-office distal Symes lesser toe amputation: a safe, reliable and cost effective treatment of diabetes-related tip of toe ulcers complicate by osteomyelitis. J Foot Ankle Surg 53: 720, 2014."},{"key":"B20","series-title":"Semin Vasc Surg","first-page":"43","article-title":"The diabetic foot: pathophysiology, evaluation, and treatment","volume":"31","author":"Bandyk DF","year":"2018","unstructured":"Bandyk DF: The diabetic foot: pathophysiology, evaluation, and treatment. Semin Vasc Surg 31: 43, 2018."},{"key":"B21","series-title":"JAPMA","first-page":"412","article-title":"Assessment of partial first-ray resections and their tendency to progress to transmetatarsal amputations: a retrospective study","volume":"102","author":"Kadukammakal J","year":"2012","unstructured":"Kadukammakal J, Yau S, Urbas W: Assessment of partial first-ray resections and their tendency to progress to transmetatarsal amputations: a retrospective study. JAPMA 102: 412, 2012."},{"key":"B22","series-title":"Diabet Foot Ankle","first-page":"12169","article-title":"Incidence of re-amputation following partial first ray amputation associated with diabetes mellitus and peripheral sensory neuropathy: a systematic review","volume":"3","author":"Borkosky SL","year":"2012","unstructured":"Borkosky SL, Roukis TS: Incidence of re-amputation following partial first ray amputation associated with diabetes mellitus and peripheral sensory neuropathy: a systematic review. Diabet Foot Ankle 3: 12169, 2012."},{"issue":"suppl 1","key":"B23","series-title":"Diabetes Metab Res Rev","first-page":"e3276","article-title":"Guidelines on diagnosis, prognosis, and management of peripheral artery disease in patients with foot ulcers and diabetes (IWGDF 2019 update)","volume":"39","author":"Hinchcliffe RJ","year":"2020","unstructured":"Hinchcliffe RJ, Forsythe RO, Apelqvist J: Guidelines on diagnosis, prognosis, and management of peripheral artery disease in patients with foot ulcers and diabetes (IWGDF 2019 update). Diabetes Metab Res Rev 39(suppl 1): e3276, 2020."}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/115\/2\/23-085.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/115\/2\/23-085.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/115\/2\/23-085.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:20:03Z","timestamp":1783506003000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/115\/2\/23085"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":23,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.7547\/23-085","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}