Modalities of Soft-Tissue Coverage in Diabetic Foot Ulcers

2015 ◽  
Vol 28 (4) ◽  
pp. 157-162 ◽  
Author(s):  
Sohaib Akhtar ◽  
Imran Ahmad ◽  
A.H. Khan ◽  
M. Fahud Khurram
Keyword(s):  
Soft Tissue ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Soft Tissue Coverage ◽  
Diabetic Foot Ulcers

Wound fluid lactate concentration: a helpful marker for diagnosing soft-tissue infection in diabetic foot ulcers? Preliminary findings

2011 ◽  
Vol 28 (2) ◽  
pp. 175-178 ◽  
Author(s):  
M. Löffler ◽  
D. Zieker ◽  
J. Weinreich ◽  
S. Löb ◽  
I. Königsrainer ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Diabetic Foot ◽  
Lactate Concentration ◽  
Tissue Infection ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Fluid

Antibiotic Resistance in Diabetic Foot Soft Tissue Infections: A Series From Greece

2017 ◽  
Vol 16 (4) ◽  
pp. 255-259 ◽  
Author(s):  
Maria Demetriou ◽  
Nikolaos Papanas ◽  
Periklis Panagopoulos ◽  
Maria Panopoulou ◽  
Efstratios Maltezos
Keyword(s):  
Antibiotic Resistance ◽  
Soft Tissue ◽  
Diabetic Foot ◽  
Soft Tissues ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Soft Tissue Infections ◽  
Diabetic Foot Infections ◽  
Initial Choice ◽  
Gram Positive Cocci

Diabetic foot infections are a common and serious problem for all health systems worldwide. The aim of this study was to examine the resistance to antibiotics of microorganisms isolated from infected soft tissues of diabetic foot ulcers, using tissue cultures. We included 113 consecutive patients (70 men, 43 women) with a mean age of 66.4 ± 11.2 years and a mean diabetes duration of 14.4 ± 7.6 years presenting with diabetic foot soft tissue infections. Generally, no high antibiotic resistance was observed. Piperacillin-tazobactam exhibited the lowest resistance in Pseudomonas, as well as in the other Gram-negative pathogens. In methicillin-resistant Staphylococcus aureus isolates, there was no resistance to anti-Staphylococcus agents. Of note, clindamycin, erythromycin, and amoxycillin/clavulanic acid exhibited high resistance in Gram-positive cocci. These results suggest that antibiotic resistance in infected diabetic foot ulcers in our area is not high and they are anticipated to prove potentially useful in the initial choice of antibiotic regimen.

scholarly journals Interphanlangeal and First Metatarsophalangeal Joint Fusion for Osteomyelitis and Septic Arthritis in Patients with Forefoot Diabetic Foot Ulcers

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0042
Author(s):  
Martin K. Ulrich ◽  
Lukas D Iselin
Keyword(s):  
Soft Tissue ◽  
Septic Arthritis ◽  
Acute Phase ◽  
Diabetic Foot ◽  
Treatment Protocol ◽  
Metatarsophalangeal Joint ◽  
Foot Ulcers ◽  
Safe Procedure ◽  
Diabetic Foot Ulcers ◽  
First Metatarsophalangeal Joint

Category: Diabetes, infection Introduction/Purpose: In cases of Diabetic Foot ulcers over joints with assocuated septic arthritis or osteomylitis, the erradication of the infection can be difficult to achieve. In order to avoid amputations which are often associated with reduced quality of life, we try to be as conservative as possible in order to save as many big toes as possible. The backbone of our noval treatment protocol involve performing a thorough soft tissue and bony debridement, stabilizing the infected bones or joint by fusing them in the acute phase, and closing the skin over the infected ulcer. We present our experience of this concept. Methods: Retrospective study between the years 2012-2016, in a single centre, treating diabetic foot patients. 29 patients, 31 feet, were identified with IPj or 1st MTPJ fusion for Infection. All patients had a combination of bone and soft tissue infections. All patients had a preoperative radiograph, 22patients had a pre-operative MRI scan to define the extent of the bony and soft-tissue infection. In all cases the involved joint was fused in the acute phase using screws, kw’s, plates, combination of the above fusion techniques. In all cases the skin was closed above the infected ulcer. Results: Closed ulcers of the fitst ray after fusing the infected joint were achieved in 26 patients (84%) by 12 months after surgery. The radiographic fusion rate was 55% by one year after surgery while 77% of the cases were clinically stable by 1 year after surgery. 5 patients (16%) endend up with an amputation. In 4 of them the base of the proximal phalangx could be left to ensure the biomechanical properties as good as possible. 1 patient needed a BKA. In 26 patients, pathogens could be identified; in 77%, polymicrobial flora were found. Conclusion: Arthrodesis of IPJ- or 1st MTPJ in diabetic foot patients presents a successful way of treatmentin order to achieve a stable situation which allow healing of bony and soft-tissue problems. Fusing an infected joint is a safe procedure that allows maintaining functional capabilities.

scholarly journals Treatment of diabetic foot ulcers

2021 ◽  
Vol 64 (8) ◽  
pp. 529-536
Author(s):  
Jiyong Ahn
Keyword(s):  
Wound Healing ◽  
Cost Effectiveness ◽  
Soft Tissue ◽  
Diabetic Foot ◽  
Healing Process ◽  
Foot Ulcers ◽  
Wound Healing Process ◽  
Diabetic Foot Ulcers ◽  
High Quality ◽  
Dressing Materials

Background: Diabetic foot ulcers (DFUs), a risk factor for infection, remain a difficult clinical complication. Infected DFUs may be associated with lower extremity amputation. To achieve wound healing and avoid amputation, an assortment of dressing materials and negative pressure wound therapy (NPWT) have been used on soft tissue injuries resulting from infected DFUs. A great deal of interest about the use of dressing materials and NPWT in the treatment of DFUs has arisen. However, there have only been a few high-quality studies regarding this topic.Current Concepts: Ideal dressing materials should satisfy certain conditions to alleviate symptoms of DFU infection and enhance the wound healing process. A single dressing material cannot fulfill all of these requirements. Based on clinical trials, different dressing materials must be chosen according to the status of the individual wound environment, including the amount of exudate, degree of pain, severity of the infection, and cost-effectiveness. However, there has been no clear evidence that advanced wound dressing materials are superior to basic dressing materials in wound healing. Recently, NPWT has been used to cover the soft tissue defects of infected DFU with granulation tissue. NPWT may contribute to changing growth factor expression, micro- and macro-deformation, vascular flow, amount of exudate, and the bacterial environment in DFU, despite the unclear mechanism of its role in wound repair.Discussion and Conclusion: Further research to obtain high-quality evidence regarding the benefits of using dressing materials and NPWT is needed. The optimal protocol for DFU and cost-effectiveness should be included in these future studies.

scholarly journals Prolonged Use of Ertapenem to Treat Infected Diabetic Foot Ulcers

2010 ◽  
Vol 2010 ◽  
pp. 1-4
Author(s):  
Ashwin Algudkar ◽  
Gidon Ellis ◽  
Fareeduddin Ahmad ◽  
Hilary Tindall
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Diabetic Foot ◽  
Complete Resolution ◽  
Marked Improvement ◽  
Severe Infection ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Unsuccessful Treatment ◽  
Intravenous Antibiotics

We present the case of a diabetic man who was successfully treated with ertapenem for over 4 months for severe infection of his foot ulcers. After initial unsuccessful treatment with empirical intravenous antibiotics, ertapenem was started on microbiology advice and led to a marked improvement in the soft-tissue infection. Ertapenem was continued for a total of 137 days under close clinical and biochemical monitoring and produced a complete resolution of the foot infection. This is the first documented case that we know of in which ertapenem has been safely used for this duration of time.

Depression Doubles Risk For Diabetic Foot Ulcers

2009 ◽  
Vol 42 (12) ◽  
pp. 14
Author(s):  
KATE JOHNSON
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

Abstract #295 Epidemiologic and Clinical Characteristics of Diabetic Foot Ulcers – Report From South West Nigeria

2019 ◽  
Vol 25 ◽  
pp. 121-122
Author(s):  
Olufunmilayo Adeleye ◽  
Ejiofor Ugwu ◽  
Anthonia Ogbera ◽  
Akinola Dada ◽  
Ibrahim Gezawa ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Clinical Characteristics ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
South West

Biologics for Diabetic Foot Ulcers Often Delayed

2010 ◽  
Vol 40 (15) ◽  
pp. 29
Author(s):  
SHARON WORCESTER
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers
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