No Routine Control Measurements of C-Reactive Protein in Uneventful Postoperative Evolution After Debridement for Infected (Diabetic) Foot Surgery

Background: /Objectives: In orthopedic (diabetic) foot surgery, the serum C-reactive protein (CRP) is frequently measured not only as a diagnostic tool, but also as a control inflammatory marker in the follow-up of operated surgical site infections (SSI) Methods: We investigate the predictive value of the post-debridement routine (control) serum CRP level in adult (diabetic) patients with SSI in the foot. We exclude community-acquired (diabetic foot) infections and focus on the predictive accuracy of routine (control) CRP measurements in terms of ultimate therapeutics failures. Results: The median pre- and postoperative CRP were 25 mg/L and 8.8 mg/L, respectively. In group comparisons and multivariate assessment, neither the immediate (relative and absolute) drop of the serum CRP level, nor its values between 5 and 8 weeks and between 11 and 14 weeks predicted the failure risk of 19%. In contrast, in cases of a surprisingly elevated CRP levels, this finding leads to unnecessary radiological, clinical and laboratory exams during clinical treatment of infections. Conclusions: Routine, postoperative CRP monitoring during the treatment of established (diabetic) foot SSIs is futile, unnecessarily costly, and should be avoided in favor of a clinical surveillance of the postoperative evolution.