diabetic%20foot%20infection
DIABETIC FOOT INFECTION

Diabetic foot infection occurs in patients with diabetes as they are prone to microorganism invasion and multiplication in the soft tissue or bone (anywhere below the malleoli) that leads to host inflammatory response that usually results to tissue destruction.

Staphylococci and streptococci are the most common causative organisms although most diabetic foot infections are polymicrobial.

Most infections usually start with a break in the protective cutaneous envelope of the skin that resulted from trauma or neuropathic ulceration.

Management of diabetic foot ulcer in patients with diabetes needs an interdisciplinary approach to address glycemic control, infection, offloading of high-pressure areas, lower extremity vascular status and local wound care.

  1. Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med. 2017;376:2367-2375. doi: 10.1056/NEJMra1615439. Accessed 22 Jun 2017. PMID: 28614678
  2. Frykberg RG. Diabetic foot ulcers: pathogenesis and management. Am Fam Physician. 2002 Nov;66(9):1655-1662. https://www.ncbi.nlm.nih.gov/pubmed/12449264. PMID: 12449264
  3. Canadian Diabetes Association Clinical Practice Guidelines Expert Committee, Bowering K, Embil JM. Foot care. Can J Diabetes. 2013 Apr;37(Suppl 1):S145-S149. doi: 10.1016/j.jcjd.2013.01.040. PMID: 24070938
  4. Gemechu FW, Seemant F, Curley CA. Diabetic foot infections. Am Fam Physician. 2013 Aug;88(3):177-184. www.aafp.org. . PMID: 23939696
  5. Lipsky BA, Aragon-Sanchez J, Diggle M, et al. International Working Group on the Diabetic Foot (IWGDF) guidance on the diagnosis and management of foot infections n persons with diabetes. Diabetes Metab Res Rev. 2016 Jan;32(Suppl 1):45-74. doi: 10.1002/dmrr.2699. PMID: 26386266
  6. Lipsky BA, Berendt AR, Cornia PB, et al. 2012 Infectious Diseases Society of America (IDSA) clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012 Jun;54(12):e132-e173. doi: 10.1093/cid/cis346. PMID: 22619242
  7. National Institute for Health and Care Excellence. Diabetic foot problems: prevention and management. NICE. www.nice.org.uk. Jan 2016.
  8. American Diabetes Association. 10. Microvascular complications and foot care: Standards of medical care in diabetes-2018. Diabetes Care. 2018 Jan;41(Suppl 1):S105-S118. doi: 10.2337/dc18-S010. PMID: 29222381
  9. Jain, A K C. A new classification of diabetic foot complications: a simple and effective teaching tool. J Diab Foot Comp. 2012;4(1):1-5.
  10. Oyibo SO, Jude EB, Tarawneh I, et al. A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care. 2001 Jan;24(1):84-88. PMID: 11194247
  11. Berlanga-Acosta J, Fernández-Montequín J, Valdés-Pérez C, et al. Diabetic foot ulcers and epidermal growth factor: revisiting the local delivery route for a successful outcome. Biomed Res Int. 2017;2017:2923759. doi: 10.1155/2017/2923759. PMID: 28904951
  12. Tsang MW, Wong WK, Hung CS, et al. Human epidermal growth factor enhances healing of diabetic foot ulcers. Diabetes Care. 2003 Jun;26(6):1856-1861. PMID: 12766123
  13. American Diabetes Association. 11. Microvascular Complications and Foot Care: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019 Jun;42(Suppl 1):S124-S138. doi: 10.2337/dc19-S011. PMID: 30559237
  14. International Working Group on the Diabetic Foot (IWGDF). IWGDF Guideline on the prevention of foot ulcers in persons with diabetes. IWGDF. https://iwgdfguidelines.org/. 2019.
  15. Ministry of Health Malaysia. Clinical practice guideline: Management of diabetic foot. 2nd ed. Ministry of Health Malaysia. http://www.moh.gov.my/. 2018.
  16. Ministry of Health Singapore. Appropriate care guide: Foot assessment in people with diabetes. Ministry of Health Singapore. http://www.ace-hta.gov.sg/. Jun 2019.
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