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Diabetic foot infections are an increasingly common problem, butproper care can save limbs and, ultimately, lives, suggest newguidelines released by the Infectious Diseases Society of America(IDSA). Poor treatment of infected foot wounds in people with diabetes can lead to lower extremity amputation, and about 50 percent ofpatients who have foot amputations die within five years - a worsemortality rate than for most cancers . But about half of lower extremity amputations that aren't causedby trauma can be prevented through proper care of foot infections,note the new IDSA diabetic foot infections guidelines, which arepublished in the journal Clinical Infectious Diseases . Because people with diabetes often have poor circulation and littleor no feeling in their feet, a sore caused by a rubbing shoe or acut can go unnoticed and worsen. As many as one in four people withdiabetes will have a foot ulcer - an open sore - in their lifetime.These wounds can easily become infected. Unchecked, the infectioncan spread, killing soft tissue and bone. Dead and infected tissuemust 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 peoplewith diabetes - and 85 percent of those begin with a foot ulcer. "Lower extremity amputation takes a terrible toll on the diabeticpatient," said Benjamin A. Lipsky, MD, chair of the review panel,lead author of the guidelines and professor of medicine at theUniversity of Washington and VA Puget Sound, Seattle. "People whohave had a foot amputated often can no longer walk, theiroccupational and social opportunities shrink, and they often becomedepressed and are at significant risk for a second amputation.Clearly, preventing amputations is vital, and in most cases,possible." The guidelines emphasize the importance of rapid and appropriatetherapy for treating infected wounds on the feet, typicallyincluding surgical removal (debridement) of dead tissue,appropriate antibiotic therapy and, if necessary, removing pressure on the wound andimproving blood flow to the area. Many patients with footinfections initially receive only antibiotic therapy, which isoften insufficient in the absence of proper wound care and surgicalinterventions, the guidelines note. Because treatment of diabetic foot infections can be complicated,the best approach is to involve a multidisciplinary team that canassess and address various aspects of the problem, suggest theguidelines, which are a revision and update of IDSA's 2004 diabeticfoot infections guidelines. Research since the previous guidelines shows that many footinfections are treated improperly, including prescribing the wrongantibiotic 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 guidelinesdetermined were most likely to help a health care provider treatinga patient with diabetes who has a foot wound. The first step is todetermine if the wound is infected, which the guidelines note islikely if there are at least two of the following signs: redness,warmth, tenderness, pain or swelling. About half of ulcers are notinfected and therefore should not be treated with antibiotics, theguidelines note. People with infections do need antibiotic therapyand those with a severe infection should be hospitalizedimmediately. When a foot sore is infected, imaging the foot is usually necessaryto determine if the bone is infected. It is also important toperform a culture of the wound to determine the bacteria causingthe infection, which will then help guide which antibiotic shouldbe used for treatment. Because of the complexity of diabetic footinfections, the guidelines suggest these patients are best servedby a multidisciplinary team, including infectious diseasesspecialists, podiatrists, surgeons and orthopedists. In ruralareas, doctors may be able to use telemedicine to consult with theappropriate experts, Dr. Lipsky said. "There is quite a bit of over-prescribing or inappropriateprescribing of antibiotics for diabetic foot wounds, which doesn'thelp the patient and can lead to antibiotic resistance," saidWarren S. Joseph, DPM, co-author of the guidelines and consultantfor lower extremity infectious diseases at Roxborough MemorialHospital, Philadelphia. "The guidelines note that when antibioticsare necessary they should be discontinued when the infection isgone, even if the wound hasn't completely healed." The voluntary guidelines are not intended to take the place of adoctor's judgment, but rather to support the decision-makingprocess, which must be individualized according to each patient'scircumstances. Additional References Citations. The e-commerce company in China offers quality products such as LED Ceiling Light Fittings , Led Ceiling Panel Light, and more. For more , please visit Led Outside Flood Lights today!
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