Significance of Surgical Intervention in the Management of Diabetic Foot Infections

Abstract

The incidence of diabetes is increasing at an alarming rate. Diabetic foot is a major cause of frequent hospital visits and extended stays. Both micro and macro-vascular abnormality play a role in its pathogenesis; i.e., it can be neuropathic or ischemic. Other factors such as impaired immunity, poor tissue reparative process and altered foot anatomy further deteriorate wound condition. Infection complicates the wound, delays healing and is a major cause of amputations. Infection control is the primary target for effective wound healing. This can be achieved by appropriate antibiotic selection and surgical intervention. Incision, drainage, debridement, revascularization and wound closure are the key surgical procedures for the management of diabetic foot infection. Careful evaluation of clinical and laboratory findings helps to determine the associated risk of organ involvement, complexity of the wound and severity of infection, as well as the timing of surgical interventions. This chapter provides an overview of diabetic foot infection and its management, with emphasis on surgical intervention. © 2014 Elsevier Inc. All rights reserved.