Diabetic Foot Infections
Key Points
Key Points
Assessment
...ssessmen...
...luate a diabetic patient presenting with a foot...
...on based on the presence of at least two clas...
...re of factors that increase the risk for...
...limb and foot for arterial ischemia, (SR, M)2...
...iency, presence of protective sensat...
...1. Interpretation of the Results of...
...nsultation...
...both outpatients and inpatients with a DFI,...
...ic foot care teams can include (or sho...
...icians without adequate training in wound debrid...
...there is clinical or imaging evide...
...linicians unfamiliar with pressure...
...ith inadequate access to consultation from special...
Hospitalization
Hospitalizati...
...nts with a severe infection, selected patie...
Prior to being discharged a patient with a DFI...
Microbiology
...obiology
...uninfected wounds, do NOT collect a specimen f...
...nfected wounds, send appropriately o...
...may be unnecessary for a mild infectio...
Specimens for culture should be from deep tis...
Imaging Studies
...maging Studie...
...senting with a new DFI should have pla...
...etic resonance imaging (MRI) is the study of choi...
...vailable or contraindicated, consider the combinat...
Treatment
...reatme...
...ecting and Modifying an Antibiotic Re...
...linically uninfected wounds should NOT b...
...e antibiotics for all infected wou...
...should select an empirical antibioti...
...rate infections in patients who have not recentl...
...infections, start broad-spectrum empiric anti...
...herapy directed at Pseudomonas aeruginosa is us...
...onsider providing empiric therapy di...
...e definitive therapy on both the results of an ap...
...oute of therapy largely on infection...
...icians can probably use highly bioava...
...ntinue antibiotic therapy until, but not...
...biotic course for a soft tissue infec...
...omyelitis...
...sider osteomyelitis as a potential comp...
...to bone (PTB) test for any DFI wit...
...diographs of the foot, although they have relati...
...: Consider using serial plain radiog...
...or a diagnostic imaging test for DFO...
...not always necessary for diagnosing or manag...
...I is unavailable or contraindicated, consider...
...e: No other types of nuclear medici...
...e most definitive way to diagnose DFO is by the co...
...ebrided to treat osteomyelitis, send a sample...
...not undergoing bone debridement, conside...
...g either primarily surgical or primaril...
...resection leaves no remaining infe...
...hen there is persistent infected or necrotic b...
...pecifically treating DFO, IDSA does NOT currently...
...al Intervention...
...inicians should consider requesting...
...ns should debride any wound that has ne...
...cal intervention is required for mos...
...lar surgeon early on to consider revascularizati...
...lthough most qualified surgeons can perfor...
...und Car...
..., aimed at removing debris, eschar and surroundi...
...r surgical) methods are generally best...
...autolytic or larval debridement tech...
...essure off the wound to the entire weight-beari...
...ressings that allow for moist wound healing and...
...cal antimicrobials are not necessa...
...ered skin equivalents, (WR, M)2...
...factors, (WR, M)21881...
...cyte colony stimulating factors, (WR, M)...
...c oxygen therapy, (SR, M)21881...
...ive pressure wound therapy. (WR, L)21...
...Microbiology of DFIs Aerobes Stap...
...able 3. IDSA and International Worki...
...Wound ScoreHaving trouble viewing table...
...Recommendations for Collection of Spec...
...iotic Selection Overview: Question...
...Suggested Empirical Antibiotic Regimens Bas...
...gnostic Bone Biopsy is Most Recommended When:...
...9. Approach to Treating a Patient with Diabetic F...
...uggested Route, Setting, and Duration of An...
...igns of a Possible Imminent Limb-Threatenin...
...estions to Ask When Dealing with Non...
Figure 1. Schematic Diagram of Cross-Secti...
...gure 2. Approach to the Infected Diab...