Correct Treatment Can Reduce Amputations

Graphic: Diabetic foot 

Diabetic foot infections are an increasingly common problem, but proper care can save limbs and, ultimately, lives, suggest new guidelines released by the Infectious Diseases Society of America (IDSA).

Poor treatment of infected foot wounds in people with diabetes can lead to lower extremity amputation, and about 50 per cent of patients who have foot amputations die within five years – a worse mortality rate than for most cancers. But about half of lower extremity amputations that are not caused by trauma can be prevented through proper care of foot infections, note the new IDSA diabetic foot infections guidelines.

Because people with diabetes often have poor circulation and little or no feeling in their feet, a sore caused by a rubbing shoe or a cut can go unnoticed and worsen. As many as one in four people with diabetes will have a foot ulcer – an open sore – in their lifetime.

These wounds can easily become infected. Unchecked, the infection can spread, killing soft tissue and bone. Dead and infected tissue must be surgically removed, which, if the infection is extensive, can mean amputation of the toe, foot, or even part of the leg. Nearly 80 per cent of all nontraumatic amputations occur in people with diabetes – and 85 per cent of those begin with a foot ulcer.

"Lower extremity amputation takes a terrible toll on the diabetic patient," said Benjamin A. Lipsky of the University of Washington. "People who have had a foot amputated often can no longer walk, their occupational and social opportunities shrink, and they often become depressed and are at significant risk for a second amputation. Clearly, preventing amputations is vital, and in most cases, possible."

The guidelines emphasize the importance of rapid and appropriate therapy for treating infected wounds on the feet, typically including surgical removal (debridement) of dead tissue, appropriate antibiotic therapy and, if necessary, removing pressure on the wound and improving blood flow to the area. Many patients with foot infections initially receive only antibiotic therapy, which is often insufficient in the absence of proper wound care and surgical interventions, the guidelines note.

REHACARE.de; Source: Infectious Diseases Society of America

- More about the Infectious Diseases Society of America at: www.idsociety.org