What's the Value of Intraoperative Bone Cultures in Managing Foot Infections?

One of the most common clinical concerns regarding patients who require toe or transmetatarsal amputations for severe infections is whether all infected bone has been resected. International guidelines recommend performing both culture and histologic assessment of residual marginal bone to guide management in this setting, but there are limited data supporting this approach.

Now, Swiss investigators have conducted a prospective 2-year study to compare cultures and histological analyses of biopsy specimens obtained intraoperatively from patients who had toe or forefoot amputations.

Of specimens obtained from 51 patients, 65% had a positive culture of residual microbial pathogens (common skin commensals were excluded). However, only 27% had his…