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Understanding Diabetic Foot Infection and its Management.
Diabetes Metab Syndr. 2017 Apr - Jun; 11(2):149-156.DM

Abstract

Diabetic Foot Ulcers (DFUs), a dreadful micro-vascular complication is liable for substantial increase in morbidity and mortality. DFU is a complicated amalgam of neuropathy, peripheral arterial diseases, foot deformities and infection. Spanning the spectrum from superficial cellulitis, microbial flora leads to chronic ostemyelitis and gangrenous extremity lower limb amputations. Wounds without affirmation of soft tissue or bone infection do not require antibiotic therapy. Treatment of mild and moderate infection requires empiric therapy covering gram-positive cocci, whereas severe or infection caused by drug resistant organisms needs broad spectrum anti-microbial targeting aggressive gram-negative aerobes and obligate anaerobes. Definitive therapy employed should be based on culture reports and clinical response. Evaluation of bone infection requires imaging by plain radiographs or MRI to increase sensitivity and specificity. Surgical interventions are must and may range from minor debridement to resections or revascularization and major amputations depending upon wound severity. On time and forceful management of diabetic foot ulcers by employing multidisciplinary management approaches focusing on prevention, learning, regular foot assessment, aggressive intervention, and optimal use of therapeutic footwear can often prevent exacerbation of the difficulty and eliminate the potential for amputation. Here, we review recent studies addressing diabetic foot infections with emphasis on pathophysiology, exclusive risk factors; evaluation including physical inspection, laboratory investigations, relevant treatment strategies and assessment of infection severity.

Authors+Show Affiliations

Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N Medical College, Aligarh Muslim University, Aligarh, India. Electronic address: sabanooramu@gmail.com.Department of General Surgery, Integral Institute of Medical Science and Research, Lucknow, India. Electronic address: ukhan.rizwan@gmail.com.Rajiv Gandhi Centre for Diabetes and Endocrinology, J.N Medical College, Aligarh Muslim University, Aligarh, India. Electronic address: jamalahmad11@rediffmail.com.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

27377687

Citation

Noor, Saba, et al. "Understanding Diabetic Foot Infection and Its Management." Diabetes & Metabolic Syndrome, vol. 11, no. 2, 2017, pp. 149-156.
Noor S, Khan RU, Ahmad J. Understanding Diabetic Foot Infection and its Management. Diabetes Metab Syndr. 2017;11(2):149-156.
Noor, S., Khan, R. U., & Ahmad, J. (2017). Understanding Diabetic Foot Infection and its Management. Diabetes & Metabolic Syndrome, 11(2), 149-156. https://doi.org/10.1016/j.dsx.2016.06.023
Noor S, Khan RU, Ahmad J. Understanding Diabetic Foot Infection and Its Management. Diabetes Metab Syndr. 2017 Apr - Jun;11(2):149-156. PubMed PMID: 27377687.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Understanding Diabetic Foot Infection and its Management. AU - Noor,Saba, AU - Khan,Rizwan Ullah, AU - Ahmad,Jamal, Y1 - 2016/06/18/ PY - 2016/06/14/received PY - 2016/06/17/accepted PY - 2016/7/6/pubmed PY - 2018/2/24/medline PY - 2016/7/6/entrez SP - 149 EP - 156 JF - Diabetes & metabolic syndrome JO - Diabetes Metab Syndr VL - 11 IS - 2 N2 - Diabetic Foot Ulcers (DFUs), a dreadful micro-vascular complication is liable for substantial increase in morbidity and mortality. DFU is a complicated amalgam of neuropathy, peripheral arterial diseases, foot deformities and infection. Spanning the spectrum from superficial cellulitis, microbial flora leads to chronic ostemyelitis and gangrenous extremity lower limb amputations. Wounds without affirmation of soft tissue or bone infection do not require antibiotic therapy. Treatment of mild and moderate infection requires empiric therapy covering gram-positive cocci, whereas severe or infection caused by drug resistant organisms needs broad spectrum anti-microbial targeting aggressive gram-negative aerobes and obligate anaerobes. Definitive therapy employed should be based on culture reports and clinical response. Evaluation of bone infection requires imaging by plain radiographs or MRI to increase sensitivity and specificity. Surgical interventions are must and may range from minor debridement to resections or revascularization and major amputations depending upon wound severity. On time and forceful management of diabetic foot ulcers by employing multidisciplinary management approaches focusing on prevention, learning, regular foot assessment, aggressive intervention, and optimal use of therapeutic footwear can often prevent exacerbation of the difficulty and eliminate the potential for amputation. Here, we review recent studies addressing diabetic foot infections with emphasis on pathophysiology, exclusive risk factors; evaluation including physical inspection, laboratory investigations, relevant treatment strategies and assessment of infection severity. SN - 1878-0334 UR - https://www.unboundmedicine.com/medline/citation/27377687/Understanding_Diabetic_Foot_Infection_and_its_Management_ DB - PRIME DP - Unbound Medicine ER -
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