Article

Diabetic Foot Ulcers and Infections: Current Concepts

Department of Orthopaedics and Rehabilitation, University of Texas Medical Branch, Galveston, USA.
Advances in Skin & Wound Care (Impact Factor: 1.11). 12/2001; 15(1):31-42; quiz 44-5. DOI: 10.1097/00129334-200201000-00011
Source: PubMed

ABSTRACT

PURPOSE: To offer an educational experience that will help improve the participant's understanding of diabetic foot ulcers and infections.
TARGET AUDIENCE: This CME/CE activity is intended for physicians and nurses with an interest in the prevention and treatment of diabetic foot ulcers and infections.
LEARNING OBJECTIVES:
1. Describe the factors that put a diabetic patient's foot at risk for ulceration.
2. Identify the components of optimal treatment of diabetic foot ulcers.
3. Explain the roles of vascular and orthopaedic surgery in the treatment of diabetic foot ulcers and infections.

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    • "While leukocytes are plentiful in the chronic wound environment, their phagocytosis, chemotaxis, and bactericidal activity appears to be diminished, at least in chronic diabetic wounds (Calhoun et al., 2002; Naghibi et al., 1987; Nolan et al., 1978; Zykova et al., 2000). "
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    ABSTRACT: Microbes colonizing and/or infecting chronic wounds undoubtedly play a major and interactive role in impaired healing, especially in amplifying and perpetuating the host innate immune response. The development of molecular techniques to identify and quantify microbial organisms has revolutionized our view of the microbial world. These less-biased, high throughput methods greatly enable investigations regarding host-microbe interactions in the chronic wound environment. This review focuses on the mounting evidence implicating microbes and excessive inflammation in chronic wounds, as well as the challenges associated with understanding how microbes modulate wound healing and the innate immune response.
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    ABSTRACT: Diabetes is an increasingly serious health issue in the rehabilitation population. Foot ulcers develop in approximately 15% of people with diabetes and are a preceding factor in approximately 85% of lower limb amputations. Nurses have significant opportunity to positively influence client outcomes and quality of life by promoting maintenance of healthy feet, identifying emerging problems, and supporting evidence-based self-care and interdisciplinary intervention. Best practice guidelines (BPG), such as those developed by the Registered Nurses Association of Ontario, provide a framework to enhance nursing practice and promote excellence in client care. This article highlights key evidence from the BPG, "Assessment and Management of Foot Ulcers for People with Diabetes," and other relevant diabetes literature. This information better equips rehabilitation nurses to promote ulcer prevention strategies; identifies key factors in ulcer risk; and utilizes current, best evidence for ulcer assessment, management, and evaluation.
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    ABSTRACT: This study was undertaken to describe the patients treated by the Austin Health High Risk Foot Clinic for diabetes related foot ulcers and to illustrate the evolution of data collection within this service, highlighting specific data for inclusion. Prospective collection of data for all patients with diabetes and a foot ulcer attending the High Risk Foot Clinic between January 2000 and February 2005 were reviewed retrospectively. During this period 162 patients with a foot ulcer related to diabetes were seen and referral was predominantly from the outpatient clinic of the hospital. Over 70% of patients were aged >60 years and almost two thirds were men. Over 75% were diagnosed with diabetes for
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