Diagnosis and Management of Diabetic Foot Infections

Andrew J.M. Boulton; David G. Armstrong; Matthew J. Hardman; Matthew Malone; John M. Embil; Christopher E. Attinger; Benjamin A. Lipsky; Javier Aragón-Sánchez; Ho Kwong Li; Gregory Schultz; Robert S. Kirsner

doi:10.2337/db2020-01

Diagnosis and Management of Diabetic Foot Infections

Review

Arlington (VA): American Diabetes Association; 2020 Jan.

ADA Clinical Compendia Series.

Authors

Andrew J.M. Boulton^{1

2}, David G. Armstrong^{3

4}, Matthew J. Hardman⁵, Matthew Malone^{6

7}, John M. Embil⁸, Christopher E. Attinger⁹, Benjamin A. Lipsky^{10

11}, Javier Aragón-Sánchez¹², Ho Kwong Li^{13

14}, Gregory Schultz¹⁵, Robert S. Kirsner²

Affiliations

¹ University of Manchester, Manchester, UK
² University of Miami Miller School of Medicine, Miami, FL
³ Keck School of Medicine of the University of Southern California, Los Angeles, CA
⁴ Southwestern Academic Limb Salvage Alliance (SALSA), Los Angeles, CA
⁵ Hull York Medical School, Hull, UK
⁶ South Western Sydney Local Health District, Limb Preservation and Wound Research Academic Unit, Ingham Institute of Applied Medical Research, Liverpool, Sydney, NSW, Australia
⁷ Western Sydney University, School of Medicine, Infectious Diseases and Microbiology, Campbelltown Campus, Sydney, Australia
⁸ Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
⁹ MedStar Georgetown University Hospital, Washington, DC
¹⁰ University of Washington School of Medicine, Seattle, WA
¹¹ Green Templeton College, University of Oxford, UK
¹² Department of Surgery and Diabetic Foot Unit, La Paloma Hospital, Las Palmas de Gran Canaria, Spain
¹³ Medical Research Council—Centre for Molecular Bacteriology & Infection, London, UK
¹⁴ Department of Infectious Disease, Imperial College London, London, UK
¹⁵ University of Florida, Gainesville, FL

PMID: 32105420
Bookshelf ID: NBK554227
DOI: 10.2337/db2020-01

Excerpt

This compendium is a follow-up to the 2018 American Diabetes Association compendium Diagnosis and Management of Diabetic Foot Complications. Whereas the first compendium offered a broad general overview of diabetic foot conditions, this second volume presents a detailed discussion of the prevention and treatment of diabetic foot infections (DFIs), a major contributor to high amputation rates among people with diabetes. The treatise begins from the viewpoint of basic science, describing the impact of infection on the healing process of experimental wounds. There follow overviews of biofilm development in chronic diabetic foot ulcers (DFUs), the microbiology of DFIs, and the crucial role of debridement in ensuring positive outcomes of DFI treatment. Next, the authors provide a practical guide to the diagnosis and clinical management of DFIs. Current controversies regarding the treatment of osteomyelitis are addressed, including the relative value of antibiotics versus surgery and the use of intravenous versus oral antibiotics. The compendium closes with a look at new topical treatments and the role of emerging technologies in infection control.

Publication types

Review

Grants and funding

This publication has been supported by unrestricted educational grants to the American Diabetes Association from Healogics, Inc., and Organogenesis, Inc.