Evaluation and treatment of the infected foot in a community teaching hospital

Abstract

More inpatient hospital days are used for the care of diabetic foot infection than for any other diabetic sequela. Both the number of lower extremity amputations and the overall treatment cost of treating diabetic infections may be reduced by using a team approach in the care of the infected diabetic pedal wound. The authors propose an evaluation and treatment protocol of infected pedal ulcerations in an urban, community teaching institution when admitted to an established, multidisciplinary diabetic foot care team. The hospital course of 111 patients admitted with a primary diagnosis of infected pedal ulceration are retrospectively reviewed. Results revealed an average-length hospital stay of 7.4 days with a 96% limb-salvage rate. The authors suggest that in the treatment of the infected pedal wound, a diabetic foot care team with a well developed treatment protocol may yield a consistently favorable outcome and a cost-effective hospital course.

Amputation in Diabetic Patients

“…60-80% of the non-traumatic amputations are performed in diabetics and there is 15 fold risk of major amputations. 45-85% of lower extremity amputations are preventable if aggressive, prompt and correct line of treatment is followed [8]. Management includes control of diabetes, treatment of infections as per culture report from deep tissue curetting and assessment of vascular status.…”

Novel antibiotics for the management of diabetic foot infections

“…This is best achieved through a multidisciplinary foot care team [31,32]. Such a multidisciplinary approach contributes to a favourable outcome and can be cost effective [32]. The team managing these infections should include, or have ready access to, an infectious diseases specialist or a medical microbiologist [7].…”

“…This is best achieved through a multidisciplinary foot care team [31,32]. Such a multidisciplinary approach contributes to a favourable outcome and can be cost effective [32].…”

Reducing Amputation Rates in Patients With Diabetes at a Military Medical Center

“…The incidence of diabetic LEAs was calculated by dividing the number of LEAs in enrolled diabetic patients, by the number of enrolled diabetic patients at MAMC for each year. Types of LEAs were compared with national averages from Centers for Disease Control and Prevention (CDC) diabetes surveillance statistics (43). Patients were selected using ICD-9-CM codes for in-patient LEA surgery on diabetic patients.…”