Title: Clinical Presentation and Treatment Guidelines for Diabetic Foot Infections in Kanyakumari District
Authors: Dr Angeline Vincent, Dr Senthil Kumar
DOI: https://dx.doi.org/10.18535/jmscr/v7i8.95
Abstract
A diabetic foot is defined as any infra malleolar infection in a person with diabetes mellitus. The morbidity of this condition and its rising incidence has implications in the management. A multidisciplinary approach by a team of physician, surgeon, social care worker, a physiotherapist, a dietician and a podiatrist is necessary. This study over a period of 3 years includes 50 patients. 90% of our patients were above 30 years. About 40% were PEDIS grade 1 or 2 i.e with mild or no infections. About 22% had PEDIS grade 4 infections, 30% had evidence of peripheral vascular disease, neurological features were seen in 24% and renal failure in 20% of our patients. 65% of our patients had inframalleolar disease whereas the rest had leg or thigh involvement. Bone was involved in 3% of our patients. More than two micro organisms were isolated in 53% of our patients. Bacterial resistance was a problem in hospitalized patients. More than 50% of the patients needed debridement. About 21% of our patients needed partial thickness skin grafting. 30% of our patients needed amputation of toes/midtarsal amputation or below knee amputation. Treatment guidelines for these patients is given here below.
Keywords: Diabetic foot infections – DFI, Soft tissue infections, Amputation.
References
- Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters Ej, Amstrong DG, et al, Infectious Diseases Society of America. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012 Jun;54(12):e132-73
- Newman AB, Siscovick DS, Manolio TA, et al. ankle-arm index as a marker of atherosclerosis in the cardiovascular health study. Cardiovascular heart study (CHS) Collaborative research group. Cirvulation. 1993;88(3):837-45
- Gregg EW, Sorlie P, Paulose-Ram, et al.Prevalence of lower-extremity disease in the US adult population ≥40 hears of age with and without diabetes: 1999-2000 national health and nutrition examination survey. Diabetes care.2004;27(7):1591-7
- Lipsky BA. Empirical therapy for diabetic foot infections: are there clinical clues to guide antibiotic selection? Clin Microbiol infect.2007;13(4):351-3
- Taylor SM, Kalbaugh CA, Blakhurst DW, et al. Preoperative clinical factors predict postoperative functional outcomes after major lower limb amputations: an analysis of 553 consecutive patients. J Vasc surg. 2005;42(2):227-35.