Abstract
The diabetic foot is particularly prone to infection from macrovascular, microvascular, immune, and biomechanical insults. Infection of diabetic foot ulcers is associated with a markedly increased risk of amputation. We herein review the practical lessons on the examination, classification, clinical and laboratory workup, and management of the infected diabetic foot.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ndosi M, Wright-Hughes A, Brown S, Backhouse M, Lipsky BA, Bhogal M, et al. Prognosis of the infected diabetic foot ulcer: a 12-month prospective observational study. Diabet Med. 2018;35(1):78–88.
Lipsky BA, Senneville É, Abbas ZG, Aragón-Sánchez J, Diggle M, Embil JM, et al. Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020;36(Suppl 1):1–24.
Tan T-W, Shih C-D, Concha-Moore KC, Diri MM, Hu B, Marrero D, et al. Disparities in outcomes of patients admitted with diabetic foot infections. PLoS One. 2019;14(2):e0211481.
Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation basis for prevention: an identifiable and potentially preventable pivotal event, in most cases an episode involving minor. Diabetes Care. 1990;13:513–21.
Hobizal KB, Wukich DK. Diabetic foot infections: current concept review. Diabet Foot Ankle. 2012:1–8.
Boulton AJM. Foot debridement: anatomic knowledge is mandatory. Diabetes Metab Res Rev. 2000;16(Suppl 1):23–6.
Zykova SN, Jenssen TG, Berdal M, Olsen R, Myklebust R, Seljelid R. Altered cytokine and nitric oxide secretion in vitro by macrophages from diabetic type II-like db/db mice. Diabetes. 2000;49(9):1451–8.
Inzucchi SE. Management of hyperglycemia in the hospital setting. N Engl J Med. 2006;355(18):1903–11.
Mazade MA, Edwards MS. Impairment of type III group B streptococcus-stimulated superoxide production and opsonophagocytosis by neutrophils in diabetes. Mol Genet Metab. 2001;73(3):259–67.
Price CL, Hassi HOSA, English NR, Blakemore AIF, Stagg AJ, Knight SC. Methylglyoxal modulates immune responses: relevance to diabetes. J Cell Mol Med. 2009;14(6b):1806–15.
Ince P, Abbas ZG, Lutale JK, Basit A, Ali SM, Chohan F, et al. Use of the SINBAD classification system and score in comparing outcome of foot ulcer management on three continents. Diabetes Care. 2008;31(5):964–7.
Zhan LX, Branco BC, Armstrong DG, Mills JL Sr. The society for vascular surgery lower extremity threatened limb classification system based on wound, ischemia, and foot infection (WIfI) correlates with risk of major amputation and time to wound healing. J Vasc Surg. 2015;61(4):939–44.
Grayson ML, Gibbons GW, Balogh K, Levin E, Karchmer AW. Probing to bone in infected pedal ulcers: a clinical sign of underlying osteomyelitis in diabetic patients. JAMA. 1995;273(9):721–3.
Armstrong DG, Perales TA, Murff RT, Edelson GW, Welchon JG. Value of white blood cell count with differential in the acute diabetic foot infection. J Am Podiatr Med Assoc. 1996;86(5):224–7.
Xu J, Cheng F, Li Y, Zhang J, Feng S, Wang P. Erythrocyte sedimentation rate combined with the probe-to-bone test for fast and early diagnosis of diabetic foot osteomyelitis. Int J Low Extrem Wounds. 2020;20:1534734620923278.
Crisologo PA, Davis KE, Ahn J, Farrar D, Van Asten S, La Fontaine J, et al. The infected diabetic foot: can serum biomarkers predict osteomyelitis after hospital discharge for diabetic foot infections? Wound Repair Regen. 2020;28(5):617–22.
Wukich DK, Hobizal KB, Brooks MM. Severity of diabetic foot infection and rate of limb salvage. Foot Ankle Int. 2013;34(3):351–8.
Nelson A, Wright-Hughes A, Backhouse MR, Lipsky BA, Nixon J, Bhogal MS, et al. CODIFI (concordance in diabetic foot ulcer infection): a cross-sectional study of wound swab versus tissue sampling in infected diabetic foot ulcers in England. BMJ Open. 2018;8(1):e019437.
Huang Y, Cao Y, Zou M, Luo X, Jiang Y, Xue Y, et al. A comparison of tissue versus swab culturing of infected diabetic foot wounds. Int J Endocrinol. 2016;2016:8198714.
Nelson EA, O’Meara S, Craig D, Iglesias C, Golder S, Dalton J, et al. A series of systematic reviews to inform a decision analysis for sampling and treating infected diabetic foot ulcers. Health Technol Assess 2006;10(12):iii–iv, ix-x, 1–221.
O’Meara S, Nelson EA, Golder S, Dalton JE, Craig D, Iglesias C, et al. Systematic review of methods to diagnose infection in foot ulcers in diabetes. Diabet Med. 2006;23(4):341–7.
Spellberg B, Lipsky BA. Systemic antibiotic therapy for chronic osteomyelitis in adults. Clin Infect Dis. 2012;54(3):393–407.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Abadeer, A.I., Abbruzzese, M.R., Davis, W. (2023). Practical Lessons Learned in Managing Diabetic Foot Infections. In: Attinger, C.E., Steinberg, J.S. (eds) Functional Limb Salvage. Springer, Cham. https://doi.org/10.1007/978-3-031-27725-2_14
Download citation
DOI: https://doi.org/10.1007/978-3-031-27725-2_14
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-27724-5
Online ISBN: 978-3-031-27725-2
eBook Packages: MedicineMedicine (R0)