Diabetic foot infections are an increasingly common problem, but proper care can save limbs and, ultimately, lives, suggest new guidelines released by the IDSA. Poor treatment of infected foot wounds in people with diabetes can lead to lower extremity amputation, and about 50 percent of patients who have foot amputations die within five years – a worse mortality rate than for most cancers.
Because people with diabetes often have poor circulation and little or no feeling in their feet, a sore caused by a rubbing shoe or a cut can go unnoticed and worsen. The guidelines emphasize the importance of rapid and appropriate therapy for treating infected wounds on the feet, typically including surgical removal (debridement) of dead tissue, appropriate antibiotic therapy and, if necessary, removing pressure on the wound and improving blood flow to the area. Because treatment of diabetic foot infections can be complicated, the best approach is to involve a multidisciplinary team that can assess and address various aspects of the problem, suggest the guidelines, which are a revision and update of IDSA's 2004 diabetic foot infections guidelines.
Research since the previous guidelines shows that many foot infections are treated improperly, including prescribing the wrong antibiotic or not addressing underlying conditions such as peripheral arterial disease. The new guidelines include 10 common questions with extensive, evidence-based answers, which the panel that wrote the guidelines determined were most likely to help a health care provider treating a patient with diabetes who has a foot wound. When a foot sore is infected, imaging the foot is usually necessary to determine if the bone is infected.
The voluntary guidelines (which can be found at the IDSA website) are not intended to take the place of a doctor's judgment, but rather to support the decision-making process, which must be individualized according to each patient's circumstances. According to a University of Texas study, Crazy Ants may become the dominant invasive ant species displacing Fire Ants in the near future. Scientists have successfully placed tiny synthetic motors in live human cells through nanotechnology. Develop and individualized meal plan with your Registered Dietitian, Nurse, Physician or Health Educator.
Diabetes complicates the microvascular circulation which decreases blood circulation and slows down healing of the infected area. But about half of lower extremity amputations that aren't caused by trauma can be prevented through proper care of foot infections, note the new IDSA diabetic foot infections guidelines, which are being published today in the journal Clinical Infectious Diseases. Many patients with foot infections initially receive only antibiotic therapy, which is often insufficient in the absence of proper wound care and surgical interventions, the guidelines note. The first step is to determine if the wound is infected, which the guidelines note is likely if there are at least two of the following signs: redness, warmth, tenderness, pain or swelling.
It is also important to perform a culture of the wound to determine the bacteria causing the infection, which will then help guide which antibiotic should be used for treatment.
Guidelines released by the Infectious Diseases Society of America (IDSA) suggests that most amputations can be prevented with proper care. About half of ulcers are not infected and therefore should not be treated with antibiotics, the guidelines note. Because of the complexity of diabetic foot infections, the guidelines suggest these patients are best served by a multidisciplinary team, including infectious diseases specialists, podiatrists, surgeons and orthopedists.
People with infections do need antibiotic therapy and those with a severe infection should be hospitalized immediately. In rural areas, doctors may be able to use telemedicine to consult with the appropriate experts, Dr. Dead and infected tissue must be surgically removed, which, if the infection is extensive, can mean amputation of the toe, foot, or even part of the leg. Nearly 80 percent of all nontraumatic amputations occur in people with diabetes – and 85 percent of those begin with a foot ulcer.
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