Expert opinion on the management of infections in the diabetic foot

B. A. Lipsky, E. J G Peters, E. Senneville, A. R. Berendt, J. M. Embil, L. A. Lavery, V. Urbančič-Rovan, W. J. Jeffcoate

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

This update of the International Working Group on the Diabetic Foot incorporates some information from a related review of diabetic foot osteomyelitis (DFO) and a systematic review of the management of infection of the diabetic foot. The pathophysiology of these infections is now well understood, and there is a validated system for classifying the severity of infections based on their clinical findings. Diagnosing osteomyelitis remains difficult, but several recent publications have clarified the role of clinical, laboratory and imaging tests. Magnetic resonance imaging has emerged as the most accurate means of diagnosing bone infection, but bone biopsy for culture and histopathology remains the criterion standard. Determining the organisms responsible for a diabetic foot infection via culture of appropriately collected tissue specimens enables clinicians to make optimal antibiotic choices based on culture and sensitivity results. In addition to culture-directed antibiotic therapy, most infections require some surgical intervention, ranging from minor debridement to major resection, amputation or revascularization. Clinicians must also provide proper wound care to ensure healing of the wound. Various adjunctive therapies may benefit some patients, but the data supporting them are weak. If properly treated, most diabetic foot infections can be cured. Providers practising in developing countries, and their patients, face especially challenging situations.

Original languageEnglish (US)
Pages (from-to)163-178
Number of pages16
JournalDiabetes/Metabolism Research and Reviews
Volume28
Issue numberSUPPL. 1
DOIs
StatePublished - Feb 2012

Fingerprint

Diabetic Foot
Expert Testimony
Infection
Osteomyelitis
Anti-Bacterial Agents
Debridement
Amputation
Wound Healing
Developing Countries
Magnetic Resonance Imaging
Biopsy
Bone and Bones
Wounds and Injuries
Therapeutics

Keywords

  • Antibiotics
  • Diabetes mellitus
  • Diabetic foot
  • Infection
  • Osteomyelitis
  • Surgery
  • Systematic review

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

Lipsky, B. A., Peters, E. J. G., Senneville, E., Berendt, A. R., Embil, J. M., Lavery, L. A., ... Jeffcoate, W. J. (2012). Expert opinion on the management of infections in the diabetic foot. Diabetes/Metabolism Research and Reviews, 28(SUPPL. 1), 163-178. https://doi.org/10.1002/dmrr.2248

Expert opinion on the management of infections in the diabetic foot. / Lipsky, B. A.; Peters, E. J G; Senneville, E.; Berendt, A. R.; Embil, J. M.; Lavery, L. A.; Urbančič-Rovan, V.; Jeffcoate, W. J.

In: Diabetes/Metabolism Research and Reviews, Vol. 28, No. SUPPL. 1, 02.2012, p. 163-178.

Research output: Contribution to journalArticle

Lipsky, BA, Peters, EJG, Senneville, E, Berendt, AR, Embil, JM, Lavery, LA, Urbančič-Rovan, V & Jeffcoate, WJ 2012, 'Expert opinion on the management of infections in the diabetic foot', Diabetes/Metabolism Research and Reviews, vol. 28, no. SUPPL. 1, pp. 163-178. https://doi.org/10.1002/dmrr.2248
Lipsky, B. A. ; Peters, E. J G ; Senneville, E. ; Berendt, A. R. ; Embil, J. M. ; Lavery, L. A. ; Urbančič-Rovan, V. ; Jeffcoate, W. J. / Expert opinion on the management of infections in the diabetic foot. In: Diabetes/Metabolism Research and Reviews. 2012 ; Vol. 28, No. SUPPL. 1. pp. 163-178.
@article{592b231d08a84010a60ba703ccdd2236,
title = "Expert opinion on the management of infections in the diabetic foot",
abstract = "This update of the International Working Group on the Diabetic Foot incorporates some information from a related review of diabetic foot osteomyelitis (DFO) and a systematic review of the management of infection of the diabetic foot. The pathophysiology of these infections is now well understood, and there is a validated system for classifying the severity of infections based on their clinical findings. Diagnosing osteomyelitis remains difficult, but several recent publications have clarified the role of clinical, laboratory and imaging tests. Magnetic resonance imaging has emerged as the most accurate means of diagnosing bone infection, but bone biopsy for culture and histopathology remains the criterion standard. Determining the organisms responsible for a diabetic foot infection via culture of appropriately collected tissue specimens enables clinicians to make optimal antibiotic choices based on culture and sensitivity results. In addition to culture-directed antibiotic therapy, most infections require some surgical intervention, ranging from minor debridement to major resection, amputation or revascularization. Clinicians must also provide proper wound care to ensure healing of the wound. Various adjunctive therapies may benefit some patients, but the data supporting them are weak. If properly treated, most diabetic foot infections can be cured. Providers practising in developing countries, and their patients, face especially challenging situations.",
keywords = "Antibiotics, Diabetes mellitus, Diabetic foot, Infection, Osteomyelitis, Surgery, Systematic review",
author = "Lipsky, {B. A.} and Peters, {E. J G} and E. Senneville and Berendt, {A. R.} and Embil, {J. M.} and Lavery, {L. A.} and V. Urbančič-Rovan and Jeffcoate, {W. J.}",
year = "2012",
month = "2",
doi = "10.1002/dmrr.2248",
language = "English (US)",
volume = "28",
pages = "163--178",
journal = "Diabetes/Metabolism Research and Reviews",
issn = "1520-7552",
publisher = "John Wiley and Sons Ltd",
number = "SUPPL. 1",

}

TY - JOUR

T1 - Expert opinion on the management of infections in the diabetic foot

AU - Lipsky, B. A.

AU - Peters, E. J G

AU - Senneville, E.

AU - Berendt, A. R.

AU - Embil, J. M.

AU - Lavery, L. A.

AU - Urbančič-Rovan, V.

AU - Jeffcoate, W. J.

PY - 2012/2

Y1 - 2012/2

N2 - This update of the International Working Group on the Diabetic Foot incorporates some information from a related review of diabetic foot osteomyelitis (DFO) and a systematic review of the management of infection of the diabetic foot. The pathophysiology of these infections is now well understood, and there is a validated system for classifying the severity of infections based on their clinical findings. Diagnosing osteomyelitis remains difficult, but several recent publications have clarified the role of clinical, laboratory and imaging tests. Magnetic resonance imaging has emerged as the most accurate means of diagnosing bone infection, but bone biopsy for culture and histopathology remains the criterion standard. Determining the organisms responsible for a diabetic foot infection via culture of appropriately collected tissue specimens enables clinicians to make optimal antibiotic choices based on culture and sensitivity results. In addition to culture-directed antibiotic therapy, most infections require some surgical intervention, ranging from minor debridement to major resection, amputation or revascularization. Clinicians must also provide proper wound care to ensure healing of the wound. Various adjunctive therapies may benefit some patients, but the data supporting them are weak. If properly treated, most diabetic foot infections can be cured. Providers practising in developing countries, and their patients, face especially challenging situations.

AB - This update of the International Working Group on the Diabetic Foot incorporates some information from a related review of diabetic foot osteomyelitis (DFO) and a systematic review of the management of infection of the diabetic foot. The pathophysiology of these infections is now well understood, and there is a validated system for classifying the severity of infections based on their clinical findings. Diagnosing osteomyelitis remains difficult, but several recent publications have clarified the role of clinical, laboratory and imaging tests. Magnetic resonance imaging has emerged as the most accurate means of diagnosing bone infection, but bone biopsy for culture and histopathology remains the criterion standard. Determining the organisms responsible for a diabetic foot infection via culture of appropriately collected tissue specimens enables clinicians to make optimal antibiotic choices based on culture and sensitivity results. In addition to culture-directed antibiotic therapy, most infections require some surgical intervention, ranging from minor debridement to major resection, amputation or revascularization. Clinicians must also provide proper wound care to ensure healing of the wound. Various adjunctive therapies may benefit some patients, but the data supporting them are weak. If properly treated, most diabetic foot infections can be cured. Providers practising in developing countries, and their patients, face especially challenging situations.

KW - Antibiotics

KW - Diabetes mellitus

KW - Diabetic foot

KW - Infection

KW - Osteomyelitis

KW - Surgery

KW - Systematic review

UR - http://www.scopus.com/inward/record.url?scp=84856198214&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856198214&partnerID=8YFLogxK

U2 - 10.1002/dmrr.2248

DO - 10.1002/dmrr.2248

M3 - Article

C2 - 22271739

AN - SCOPUS:84856198214

VL - 28

SP - 163

EP - 178

JO - Diabetes/Metabolism Research and Reviews

JF - Diabetes/Metabolism Research and Reviews

SN - 1520-7552

IS - SUPPL. 1

ER -