Management of the Diabetic Foot in People with Diabetes Mellitus Older than 65 Years

Abstract

Introduction: Diabetic foot is the infection, ulceration or destruction of the deep tissues of the foot in patients with diabetes mellitus. This pathology occurs when there are high levels of glucose in the blood, as well as other factors such as high blood pressure and hypercholesterolemia. These factors cause damage to the vessels and nerves, producing medium and long-term complications. This is a health problem that affects diabetic patients throughout their lives. Objective: To know the different techniques and strategies that allow to carry out an appropriate management of the diabetic foot. Methodology: A narrative review was carried out between November 2021 and July 2022 in the different databases of Pubmed (Medline), Scielo, Scopus and Web of Science (WOS), with a search string that combined the keywords derived from thesauri, namely Descriptors of Health Sciences (DeCS) and Medical Subject Headings (MeSH), combined with the Boolean operators “AND”, “NOT” and “NOT”. Results: After applying the article selection criteria and evaluating the quality of the methodology, a total of 22 articles were obtained. The results affirm the existence of promising therapies for the treatment of diabetic foot ulcers such as negative-pressure therapy and hyperbaric oxygen therapy. It is highlighted that the use of therapeutic footwear and health education are deficient aspects that must be reinforced. Conclusion: After comparing the different articles, it was possible to determine that negative-pressure therapy and hyperbaric oxygen therapy should be promoted as they are suitable for the treatment of diabetic foot ulcers. In addition, therapeutic footwear is a baseline in the diabetic foot approach. On the other hand, it is necessary to reinforce interdisciplinary work in this area and health education for patients suffering from this disease.

Examining the effect of polyurethane dressing containing silver particles on the rate of diabetic foot ulcer infection in hospitalized patients: A randomized control study

“…7 Diabetic foot is referred to as a set of syndromes in which neuropathy, ischemia, and infection cause tissue abnormalities or secondary ulcers to microtrauma. 8 About 15% of diabetic patients develop such a complication, and currently, about 70 million diabetic patients have foot ulcers. 9,10 These types of wounds are seen as serious and dangerous complications of diabetes since they worsen the patient's clinical condition and diminish their quality of life.…”

“…14 Thus, early diagnosis and management of diabetic foot ulcers can reduce such complications. 8 Out of different types of pathogenic organisms, Staphylococcus aureus seems to be the most common cause of infection. This finding may be effective in choosing the type of antibiotic and recommended dressing.…”

“…9,10 These types of wounds are seen as serious and dangerous complications of diabetes since they worsen the patient's clinical condition and diminish their quality of life. 8 By causing many socioeconomic effects, this complication enhances the possibility of amputation in diabetic patients. 11 If the diabetic foot wound becomes infected, the conditions will become more difficult for the patient and the healing process will be very slow.…”

“…Therefore, it requires teamwork and the participation of nursing and medical professionals. 8 Especially the nurses of diabetic patients who are responsible for dressing their wounds need to be quite familiar with the best and most effective type of new dressings and how to use them. 12 By reviewing the relevant studies conducted so far, the research team realized that there is still no consensus on the effect of Eurofarm dressing containing polyurethane foam with silver particles on diabetic foot ulcer infection.…”

“…Besides causing the death of about 4 million people every year, 3 diabetes is associated with many complications such as heart failure, 6 nephropathy, retinopathy, cataracts, and diabetic foot ulcers 7 . Diabetic foot is referred to as a set of syndromes in which neuropathy, ischemia, and infection cause tissue abnormalities or secondary ulcers to microtrauma 8 . About 15% of diabetic patients develop such a complication, and currently, about 70 million diabetic patients have foot ulcers 9,10 .…”