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Diagnosis and Treatment of Diabetic Foot Infections

Lipsky, Benjamin A., Berendt, Anthony R., Deery, H Gunner, Embil, John M., Joseph, Warren S., Karchmer, Adolf W., LeFrock, Jack L., Lew, Daniel P., Mader, Jon T., Norden, Carl, Tan, James S.·2006·Plastic and Reconstructive Surgery
DOI 10.1097/01.prs.0000222737.09322.77
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Abstract

EXECUTIVE SUMMARY: 1. Foot infections in patients with diabetes cause substantial morbidity and frequent visits to health care professionals and may lead to amputation of a lower extremity. 2. Diabetic foot infections require attention to local (foot) and systemic (metabolic) issues and coordinated management, preferably by a multidisciplinary foot-care team (A-II). The team managing these infections should include, or have ready access to, an infectious diseases specialist or a medical microbiologist (B-II). 3. The major predisposing factor to these infections is foot ulceration, which is usually related to peripheral neuropathy. Peripheral vascular disease and various immunological disturbances play a secondary role. 4. Aerobic Gram-positive cocci (especially Staphylococcus aureus) are the predominant pathogens in diabetic foot infections. Patients who have chronic wounds or who have recently received antibiotic therapy may also be infected with Gram-negative rods, and those with foot ischemia or gangrene may have obligate anaerobic pathogens. 5. Wound infections must be diagnosed clinically on the basis of local (and occasionally systemic) signs and symptoms of inflammation. Laboratory (including microbiological) investigations are of limited use for diagnosing infection, except in cases of osteomyelitis (B-II). 6. Send appropriately obtained specimens for culture before starting empirical antibiotic therapy in all cases of infection, except perhaps those that are mild and…

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Metadata

Authors
Lipsky, B. A., Berendt, A. R., Deery, H. G., Embil, J. M., Joseph, W. S., Karchmer, A. W., LeFrock, J. L., Lew, D. P., Mader, J. T., Norden, C., & Tan, J. S.
Venue
Plastic and Reconstructive Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2006-06
Volume
117
Issue
SUPPLEMENT
Pages
212S-238S
ISSN
0032-1052
DOI
10.1097/01.prs.0000222737.09322.77
Cited by
221
References
0
Language
en

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