Diabetic Foot Infections
Key Points
Key Points
Assessment
...Ass...
...aluate a diabetic patient presenting with a...
...nose infection based on the presence of at least...
...ctors that increase the risk for DFI...
...d limb and foot for arterial ischemia, (...
...nous insufficiency, presence of protective...
...Interpretation of the Results of Ankle-Brac...
...Con...
...both outpatients and inpatients with...
Diabetic foot care teams can include (or should...
...nicians without adequate training in w...
...clinical or imaging evidence of significant is...
...s unfamiliar with pressure off-loading or speci...
...s with inadequate access to consultation...
Hospitalization
...Hospitalization...
...patients with a severe infection,...
...ischarged a patient with a DFI should: (SR, L)...
Microbiology
...or clinically uninfected wounds, do...
...ected wounds, send appropriately obtained s...
Note: Cultures may be unnecessary for...
...ecimens for culture should be from d...
Imaging Studies
...Imagi...
...presenting with a new DFI should ha...
...resonance imaging (MRI) is the study...
...available or contraindicated, consider the combina...
Treatment
...Treatment...
...Selecting a...
...y uninfected wounds should NOT be...
...scribe antibiotics for all infected wound...
...ns should select an empirical antibiotic reg...
...mild to moderate infections in patients who have...
...e infections, start broad-spectrum empi...
...py directed at Pseudomonas aeruginosa is...
...r providing empiric therapy direct...
...e definitive therapy on both the results of an...
...of therapy largely on infection severity — p...
...ians can probably use highly bioavailabl...
...e antibiotic therapy until, but not beyond...
...tibiotic course for a soft tissue infection is...
...Os...
...omyelitis as a potential complication...
...erform a probe to bone (PTB) test for an...
...in radiographs of the foot, although th...
...der using serial plain radiographs...
...a diagnostic imaging test for DFO use MRI....
...MRI is not always necessary for diagnosing o...
...navailable or contraindicated, consider a l...
...ther types of nuclear medicine investigations...
...efinitive way to diagnose DFO is by the co...
...ne is debrided to treat osteomyelitis, send a samp...
...undergoing bone debridement, cons...
...sing either primarily surgical or prima...
...radical resection leaves no remaining infected...
...here is persistent infected or necrotic bon...
...r specifically treating DFO, IDSA does NOT current...
...Surgical Intervention...
Nonsurgical clinicians should conside...
...hould debride any wound that has necrotic t...
...ical intervention is required for most foo...
...scular surgeon early on to consider...
...ough most qualified surgeons can perfo...
...Wound Care...
...ent, aimed at removing debris, eschar and surround...
...rp (or surgical) methods are generally best,...
...t mechanical, autolytic or larval debridement...
...ssure off the wound to the entire weight-bearing...
...s that allow for moist wound healing and cont...
...al antimicrobials are not necessary for...
...ered skin equivalents, (WR, M)21881...
...h factors, (WR, M)21...
...te colony stimulating factors, (WR,...
...aric oxygen therapy, (SR, M)218...
or negative pressure wound therapy. (WR, L)...
...2. Microbiology of DFIs Aerobes...
...IDSA and International Working Grou...
...le 4. DFI Wound ScoreHaving trouble viewing...
...ble 5. Recommendations for Collection of Specimens...
...Antibiotic Selection Overview: Questions a Cl...
...ble 7. Suggested Empirical Antibiotic Regimens...
...Diagnostic Bone Biopsy is Most Recommended Whe...
...roach to Treating a Patient with Diabetic Foot...
...ggested Route, Setting, and Duration of Antibiot...
...Signs of a Possible Imminent Limb-Threatening...
...12. Questions to Ask When Dealing with...
.... Schematic Diagram of Cross-Secti...
...pproach to the Infected Diabetic Foot...