Diabetic Foot Infections
Key Points
Key Points
Assessment
...essment...
...ate a diabetic patient presenting with a foot wo...
...ction based on the presence of at least two...
Be aware of factors that increase the risk fo...
the affected limb and foot for arterial...
...iency, presence of protective sensatio...
...etation of the Results of Ankle-Brach...
Consultation
...patients and inpatients with a DFI, provide a wel...
Diabetic foot care teams can include (or sh...
...s without adequate training in wound debridement...
...s clinical or imaging evidence of significan...
...amiliar with pressure off-loading o...
...mmunities with inadequate access to con...
Hospitalization
...pitalization...
...th a severe infection, selected pa...
...discharged a patient with a DFI sh...
Microbiology
...obiology...
...linically uninfected wounds, do NOT collec...
...wounds, send appropriately obtained specimens...
...Cultures may be unnecessary for a mild infection...
...ulture should be from deep tissue, obtained by bi...
Imaging Studies
...ng Studies...
...atients presenting with a new DFI should have...
...nce imaging (MRI) is the study of choice for pat...
...hen MRI is unavailable or contraindicated, cons...
Treatment
...reatment
...ting and Modifying an Antibiotic Regimen...
...nfected wounds should NOT be treated with antibiot...
...otics for all infected wounds, but no...
...should select an empirical antibiotic regi...
...r mild to moderate infections in patients...
...t severe infections, start broad-spectrum...
...piric therapy directed at Pseudomonas...
...roviding empiric therapy directed agains...
...finitive therapy on both the result...
...se the route of therapy largely on infection s...
...ns can probably use highly bioavail...
...biotic therapy until, but not beyond, resolu...
...biotic course for a soft tissue infection is about...
...teomyelit...
...steomyelitis as a potential complicati...
...robe to bone (PTB) test for any DF...
...adiographs of the foot, although they ha...
...ote: Consider using serial plain radiograph...
For a diagnostic imaging test for DFO us...
...ot always necessary for diagnosing or managin...
If MRI is unavailable or contraind...
...e: No other types of nuclear medic...
...t definitive way to diagnose DFO i...
...n bone is debrided to treat osteomyel...
...or patients not undergoing bone deb...
Consider using either primarily surgical or primar...
...resection leaves no remaining infe...
...hen there is persistent infected or necrotic b...
...ifically treating DFO, IDSA does NOT c...
...cal Intervention...
...surgical clinicians should consider requesting an...
...inicians should debride any wound that has necro...
...ical intervention is required for most foot infec...
...ar surgeon early on to consider reva...
Although most qualified surgeons can perf...
...und Care
...aimed at removing debris, eschar and surround...
...te: Sharp (or surgical) methods are...
...anical, autolytic or larval debridement techniques...
...ibute pressure off the wound to the entire...
...lect dressings that allow for moist wou...
...obials are not necessary for most clinicall...
...ineered skin equivalents, (WR, M)21881...
...factors, (WR, M)21881...
...ony stimulating factors, (WR, M)21881...
hyperbaric oxygen therapy, (SR, M)218...
...pressure wound therapy. (WR, L)21881...
...2. Microbiology of DFIs Aero...
...IDSA and International Working Group on the Di...
...4. DFI Wound ScoreHaving trouble vi...
.... Recommendations for Collection of Specimens for...
...iotic Selection Overview: Questions a...
...gested Empirical Antibiotic Regimens Based on Cl...
.... Diagnostic Bone Biopsy is Most Recommended...
...Approach to Treating a Patient wit...
...ted Route, Setting, and Duration o...
...ble 11. Signs of a Possible Imminent Limb-Thr...
Table 12. Questions to Ask When Dealing with Nonre...
...Schematic Diagram of Cross-Section of the...
...ach to the Infected Diabetic Foot...