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IOS 9 Exam 4

Diabetic Foot Infections

QuestionAnswer
Pathophysiology of Diabetic foot infection is Due to Diabetic neuropathy loss of sensation, and PAD loss of blood flow, leads to altered immunity (druken Macrophages, leukocytes, neutrophils) leads to poor wound healing
Clinical presentation of diabetic foot infection Peripheral neuropathy but usually seek medical attention due to swelling or erythema in the foot.
Diabetic foot Infections are usually Polymicrobial: Staph Epidermis, Staph Aureus, Anaerobic (smell), Gram - (enterobacter, Klebsiella, proteus, pseudomonas)
Mild diabetic foot infection presentation Superficial ulceration <2cm, purulent dischargem No osteomyelitis, no systemic symptoms (fever, chills)
Treatment of Mild foot infection Amoxicillin/clau 500-750BID or Dicloxcillin 500mg PO QID, or PCN allergy Septra DS 1 PO BID for 1-2 weeks
Moderate - Severe diabetic foot infection clinical presentation Ulcerations to deep tissue wound, purulent discharge, cellulitis, systemic toxcity (fever, chills), mild/moderate necrosis, NO of osteomyelitis
Treatment of moderate-severe diabetic foot infection Pipercillin/tazobactam 4.5g IV q6hr, or Imipentem 500mg IV q8hr, or Cefotetan 2g IV q12hr, surgical drainage/excision, assess revascularization Treat 3-4 weeks
Severe Diabetic foot infection presentation Ulceration to deep tissue wound (bone), purulent discharge, cellulitis, osteomyelitis, systemic toxcity (fever, chills) with septic shock, Marked necrosis,gangrene, bacteremia
Treatment of severe diabetic foot infection Ampicillin/sulbactam 3g IV q6hr +/- aminoglycoside or Fluoroquinolone, surgical debreitment, drain, or amputation. Must control hyperglycemia and ketoacidosis, assess revascularization Treat>6weeks
Regranex can be used for Would healing wet to dry but only with depths <2cm
Prevention of Diabetic foot infection (4) Proper foot care-Avoid keratolytics, hygine, trauma, Appropiate footware, Stop smoking, Good glycemic control
Created by: liza001
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