Diabetic Foot Infections
Key Points
Key Points
Assessment
Assessm...
...betic patient presenting with a foot wound at 3...
...se infection based on the presence of a...
...of factors that increase the risk for D...
...limb and foot for arterial ischemia, (SR,...
...insufficiency, presence of protect...
...rpretation of the Results of Ankle-Brachi...
...ultation...
...tients and inpatients with a DFI, provide a well-c...
...iabetic foot care teams can include (or sh...
...icians without adequate training in wound...
...f there is clinical or imaging evidence...
...miliar with pressure off-loading or...
...ommunities with inadequate access to...
Hospitalization
...talization...
...nts with a severe infection, selected...
...ischarged a patient with a DFI sho...
Microbiology
...obiology...
...y uninfected wounds, do NOT collect a speci...
...infected wounds, send appropriately ob...
...Cultures may be unnecessary for a...
...cimens for culture should be from deep tiss...
Imaging Studies
...ng Studies...
...ll patients presenting with a new DFI should...
...etic resonance imaging (MRI) is the study...
...n MRI is unavailable or contraindicat...
Treatment
...eatment...
...d Modifying an Antibiotic Regimen (See below for...
...y uninfected wounds should NOT be treated wi...
...ibe antibiotics for all infected wo...
...icians should select an empirical antibi...
...to moderate infections in patients who ha...
...t severe infections, start broad-spectrum empiric...
...c therapy directed at Pseudomonas aeru...
...iding empiric therapy directed against methici...
...definitive therapy on both the res...
Base the route of therapy largely on i...
...an probably use highly bioavailable oral ant...
...nue antibiotic therapy until, but not beyond...
...al antibiotic course for a soft tissue infection...
...eomyelitis...
...elitis as a potential complication of a...
...to bone (PTB) test for any DFI with an ope...
...radiographs of the foot, although they have relat...
...using serial plain radiographs to diagnose or...
...gnostic imaging test for DFO use MRI...
...MRI is not always necessary for diagnosing...
...navailable or contraindicated, consid...
...No other types of nuclear medicine investigatio...
...nitive way to diagnose DFO is by the combi...
...brided to treat osteomyelitis, send a s...
...patients not undergoing bone debridement,...
Consider using either primarily surgi...
When a radical resection leaves no rem...
...hen there is persistent infected or ne...
...specifically treating DFO, IDSA does NOT cur...
...cal Intervention
...l clinicians should consider reques...
...should debride any wound that has necrotic tissu...
...surgical intervention is required for mos...
...lar surgeon early on to consider revascularizat...
Although most qualified surgeons can perform...
...und Car...
...ridement, aimed at removing debris, eschar and...
...or surgical) methods are generally best, (SR, L)21...
...nical, autolytic or larval debridemen...
...edistribute pressure off the wound to...
...ct dressings that allow for moist wound hea...
Topical antimicrobials are not necessary for mos...
...ineered skin equivalents, (WR, M)21881...
...owth factors, (WR, M)2...
...e colony stimulating factors, (WR, M)21881...
...erbaric oxygen therapy, (SR, M)2...
or negative pressure wound therapy. (WR, L)21881
...le 2. Microbiology of DFIs Ae...
...ble 3. IDSA and International Working Group...
...und ScoreHaving trouble viewing table? Expand...
...commendations for Collection of Specimens for Cu...
...ble 6. Antibiotic Selection Overvi...
...7. Suggested Empirical Antibiotic Regimens Based...
...stic Bone Biopsy is Most Recommended When: Pa...
...able 9. Approach to Treating a Patient...
...gested Route, Setting, and Duration of Antib...
...11. Signs of a Possible Imminent Limb-Thr...
...Questions to Ask When Dealing with Nonrespon...
...1. Schematic Diagram of Cross-Section of the...
...Approach to the Infected Diabetic Foot...