[Principles of treatment for deep infections of the diabetic foot].

Der Orthopäde
S KesslerC Volkering

Abstract

Infections are the typical complications of ulcers related to the neuropathic diabetic foot. The loss of the foot or sepsis is the consequence due to the progression of an untreated infection. Therefore, prophylaxis of ulcer formation is the key to lower the rate of amputation. If infection has occurred antibiotics and non-weight bearing are indicated. Abscesses and phlegmons can be localized by the clinical findings, ultrasound, x-rays, computer tomography and MRI and immediate surgical treatment is necessary to prevent further spreading. In the chronic phase dead tissue, necrotic tendons and bones need to be resected. Closure of the skin can be achieved by secondary healing or other methods of plastic surgery. Persistent bony prominences have to be removed and instabilities need fusion operations. In this way many amputations can be avoided or the extent of amputation can be noticeably reduced.

References

Nov 1, 1992·Zeitschrift für Orthopädie und ihre Grenzgebiete·B GreitemannR Baumgartner
Jul 1, 1991·Journal of the American Podiatric Medical Association·I R MitchellW A Krueger
May 1, 1994·Zeitschrift für Orthopädie und ihre Grenzgebiete·B GreitemannS Schüling
Nov 1, 1996·Radiographics : a Review Publication of the Radiological Society of North America, Inc·C D MarcusB P Menanteau
May 20, 2004·Diabetes/metabolism Research and Reviews·Benjamin A LipskyFausto De Lalla
May 12, 2006·The British Journal of Radiology·P L Tan, J Teh

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Citations

Mar 23, 2011·Der Unfallchirurg·T Mittlmeier, P Haar
Aug 21, 2009·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·H DienerE S Debus

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