Diabetic Foot Infections: Current Diagnosis and Treatment
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/580 |
Resumo: | Diabetes mellitus (DM) is a global epidemic, and diabetic foot ulcer (DFU) is one of its most serious and costly complications. DFUs result from a complex interaction of a number of risk factors. Once the protective layer of skin is broken, deep tissues are exposed to bacterial infection that progresses rapidly. Patients with DFUs frequently require amputations of the lower limbs and, in more than half the cases, infection is the preponderant factor. Given the challenges of treating these complex infections, this paper aims to provide a hospital-based framework for the diagnosis and treatment of diabetic foot infections (DFIs). We propose a treatment-oriented assessment of DFIs based on a cross-examination of the medical, foot, and wound history; a systemized and detailed physical examination; and the results of complementary diagnostic procedures. We stress the need for a clinical diagnosis of DFIs and the importance of microbiological evaluation for antibiotic therapy guidance. Regarding treatment, we propose a multidisciplinary approach prioritizing invasive infection drainage, necrosis debridement, and the prompt start of empirical antibiotic therapy, followed by complete and appropriate vascular reconstruction. For severe DFIs, we suggest that negative pressure wound therapy (NPWT) be included in the treatment pathway. We also provide rules for managing particular situations, such as osteomyelitis. It is our hope that this protocol will improve the hospital management of DFIs and, ultimately, the prognosis of DFI patients. |
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Diabetic Foot Infections: Current Diagnosis and TreatmentInfecçãoÚlcera do Pé DiabéticoOsteomieliteDiabetes mellitus (DM) is a global epidemic, and diabetic foot ulcer (DFU) is one of its most serious and costly complications. DFUs result from a complex interaction of a number of risk factors. Once the protective layer of skin is broken, deep tissues are exposed to bacterial infection that progresses rapidly. Patients with DFUs frequently require amputations of the lower limbs and, in more than half the cases, infection is the preponderant factor. Given the challenges of treating these complex infections, this paper aims to provide a hospital-based framework for the diagnosis and treatment of diabetic foot infections (DFIs). We propose a treatment-oriented assessment of DFIs based on a cross-examination of the medical, foot, and wound history; a systemized and detailed physical examination; and the results of complementary diagnostic procedures. We stress the need for a clinical diagnosis of DFIs and the importance of microbiological evaluation for antibiotic therapy guidance. Regarding treatment, we propose a multidisciplinary approach prioritizing invasive infection drainage, necrosis debridement, and the prompt start of empirical antibiotic therapy, followed by complete and appropriate vascular reconstruction. For severe DFIs, we suggest that negative pressure wound therapy (NPWT) be included in the treatment pathway. We also provide rules for managing particular situations, such as osteomyelitis. It is our hope that this protocol will improve the hospital management of DFIs and, ultimately, the prognosis of DFI patients.Journal of Diabetic Foot ComplicationsRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEMendes, JJNeves, J2012-07-10T10:53:19Z20122012-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/580engJ Diabetic Foot Complic. 2012; 4 (2): 26-45info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:27:16Zoai:repositorio.chlc.min-saude.pt:10400.17/580Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:18:20.515468Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Diabetic Foot Infections: Current Diagnosis and Treatment |
title |
Diabetic Foot Infections: Current Diagnosis and Treatment |
spellingShingle |
Diabetic Foot Infections: Current Diagnosis and Treatment Mendes, JJ Infecção Úlcera do Pé Diabético Osteomielite |
title_short |
Diabetic Foot Infections: Current Diagnosis and Treatment |
title_full |
Diabetic Foot Infections: Current Diagnosis and Treatment |
title_fullStr |
Diabetic Foot Infections: Current Diagnosis and Treatment |
title_full_unstemmed |
Diabetic Foot Infections: Current Diagnosis and Treatment |
title_sort |
Diabetic Foot Infections: Current Diagnosis and Treatment |
author |
Mendes, JJ |
author_facet |
Mendes, JJ Neves, J |
author_role |
author |
author2 |
Neves, J |
author2_role |
author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Mendes, JJ Neves, J |
dc.subject.por.fl_str_mv |
Infecção Úlcera do Pé Diabético Osteomielite |
topic |
Infecção Úlcera do Pé Diabético Osteomielite |
description |
Diabetes mellitus (DM) is a global epidemic, and diabetic foot ulcer (DFU) is one of its most serious and costly complications. DFUs result from a complex interaction of a number of risk factors. Once the protective layer of skin is broken, deep tissues are exposed to bacterial infection that progresses rapidly. Patients with DFUs frequently require amputations of the lower limbs and, in more than half the cases, infection is the preponderant factor. Given the challenges of treating these complex infections, this paper aims to provide a hospital-based framework for the diagnosis and treatment of diabetic foot infections (DFIs). We propose a treatment-oriented assessment of DFIs based on a cross-examination of the medical, foot, and wound history; a systemized and detailed physical examination; and the results of complementary diagnostic procedures. We stress the need for a clinical diagnosis of DFIs and the importance of microbiological evaluation for antibiotic therapy guidance. Regarding treatment, we propose a multidisciplinary approach prioritizing invasive infection drainage, necrosis debridement, and the prompt start of empirical antibiotic therapy, followed by complete and appropriate vascular reconstruction. For severe DFIs, we suggest that negative pressure wound therapy (NPWT) be included in the treatment pathway. We also provide rules for managing particular situations, such as osteomyelitis. It is our hope that this protocol will improve the hospital management of DFIs and, ultimately, the prognosis of DFI patients. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-07-10T10:53:19Z 2012 2012-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/580 |
url |
http://hdl.handle.net/10400.17/580 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
J Diabetic Foot Complic. 2012; 4 (2): 26-45 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Journal of Diabetic Foot Complications |
publisher.none.fl_str_mv |
Journal of Diabetic Foot Complications |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799131280320757760 |