Diabetic Foot Infections
Key Points
Key Points
Assessment
...sessment
...aluate a diabetic patient presenting w...
...tion based on the presence of at least two...
...aware of factors that increase the r...
...e affected limb and foot for arterial ischemia,...
...ufficiency, presence of protective sensation an...
...Interpretation of the Results of Ankle...
...ultation...
...or both outpatients and inpatients with a DFI, p...
...iabetic foot care teams can include (or shou...
...ut adequate training in wound debridement...
...s clinical or imaging evidence of significant...
...iliar with pressure off-loading or special dressi...
...communities with inadequate access to consul...
Hospitalization
...ospitalizatio...
...nts with a severe infection, selected...
...being discharged a patient with a DFI sho...
Microbiology
...crobiolog...
...ically uninfected wounds, do NOT collect a s...
...or infected wounds, send appropriately obt...
...: Cultures may be unnecessary for a mild infect...
...for culture should be from deep tissue...
Imaging Studies
...ng Studies...
...presenting with a new DFI should have...
...etic resonance imaging (MRI) is the study of...
...en MRI is unavailable or contraindica...
Treatment
...eatment...
...Modifying an Antibiotic Regimen (See below fo...
...cally uninfected wounds should NOT...
...antibiotics for all infected wounds, bu...
...linicians should select an empirical antibiotic r...
...oderate infections in patients who have not...
...ere infections, start broad-spectrum empiric...
...c therapy directed at Pseudomonas aeruginosa is...
...er providing empiric therapy directed against me...
...efinitive therapy on both the results...
...the route of therapy largely on inf...
...cians can probably use highly bioavailab...
...otic therapy until, but not beyond, re...
...tial antibiotic course for a soft tissue infec...
...teomyelit...
...der osteomyelitis as a potential complication...
...m a probe to bone (PTB) test for any DFI with...
...in plain radiographs of the foot, although...
...: Consider using serial plain radiograp...
...nostic imaging test for DFO use MRI...
Note: MRI is not always necessary for dia...
...ailable or contraindicated, consider...
...: No other types of nuclear medicine investigati...
...tive way to diagnose DFO is by the combi...
...ebrided to treat osteomyelitis, send a sample...
...tients not undergoing bone debridem...
...using either primarily surgical or pri...
...ical resection leaves no remaining infe...
...hen there is persistent infected or necrotic b...
...lly treating DFO, IDSA does NOT currently support...
...ical Interventio...
...clinicians should consider requesting an...
...ld debride any wound that has necrotic tissue or s...
...gent surgical intervention is required for most fo...
...a vascular surgeon early on to consider...
Although most qualified surgeons can p...
...und Care...
...t, aimed at removing debris, eschar and surroundi...
...arp (or surgical) methods are generally best, (SR...
...autolytic or larval debridement tec...
...ressure off the wound to the entire weight-be...
...that allow for moist wound healin...
...crobials are not necessary for most c...
...ineered skin equivalents, (WR,...
...owth factors, (WR, M)21881...
granulocyte colony stimulating factors, (WR, M)218...
hyperbaric oxygen therapy, (SR, M)...
...negative pressure wound therapy....
...Microbiology of DFIs Aerobes Sta...
...IDSA and International Working Group on...
...und ScoreHaving trouble viewing table?...
...ommendations for Collection of Specimens for Cult...
...tibiotic Selection Overview: Questions a Clinician...
...7. Suggested Empirical Antibiotic Regimens Base...
...e 8. Diagnostic Bone Biopsy is Most Recommended...
...e 9. Approach to Treating a Patient...
...le 10. Suggested Route, Setting, an...
...ble 11. Signs of a Possible Imminent...
...le 12. Questions to Ask When Dealing with N...
...matic Diagram of Cross-Section of the F...
...ure 2. Approach to the Infected Di...