Diabetic foot infection complications

Foot ulcers and related infections are among the most common, severe, and costly complications of diabetes mellitus (DM). Fifteen percent of all patients with DM develop at least one foot ulcer, resulting in direct health care expenditures of approximately 9 billion annually in the United States.26,27 Diabetic foot ulcers and wounds are highly susceptible to infection. Related skin, soft tissue, and bone infections account for 25% of all diabetes-related hospitalizations.28 More than half of all nontraumatic lower extremity amputations (LEAs) performed each year in Western nations are linked to diabetic foot infection 80,000 LEAs are performed annually in the United States alone.29,30... 

Spreading soft tissue infection and osteomyelitis are often the first complications that develop from diabetic foot infection. Some patients develop bacteremia and sepsis. 

A. Abdulrazak, Z.I. Bitar, A.A. Al-Shamali, L A. Mobasher, Bacteriological study of diabetic foot infections, J. Diabetes Complications, 19 (2005) 138-41. 

The most feared complication of infected diabetic foot ulcers is LEA. Diabetic patients are approximately 40 times more likely to require an amputation than nondiabetics.34 Morbidity and mortality rates are high following amputation. Mortality ranges from 40% to 80% after 5 years, generally secondary to comorbid conditions, including heart and renal disease.28,30... 

Complicated skin and skin structure infections (SSSIs) For the treatment of complicated SSSIs caused by S. aureus (methicillin-susceptible and -resistant strains). Streptococcus pyogenes, or Streptococcus agalactiae. It has not been studied in the treatment of diabetic foot and decubitus ulcers. 

Three major types of foot infections are seen in diabetic patients deep abscesses, cellulitis of the dorsum, and mal perforans ulcers. Most deep abscesses involve the central plantar space (arch) and are caused by minor penetrating trauma or by an extension of infection of a nail or web space of the toes. Skin infections of the dorsal area generally arise from infections in the toes that are related to routine care of the nails, nailbeds, and calluses of the toes. Mal perforans ulcer is a chronic ulcer of the sole of the foot. The ulcer develops on thickened, hardened calluses over the first or fifth metatarsal. Mal perforans ulcers are associated with neuropathy, which is responsible for the misalignment of the weight-bearing bones of the foot. Osteomyelitis is one of the most serious complications of foot problems in diabetic patients and may occur in 30% to 40% of infections. ... 

Eneroth M, Larsson J, Apelqvist J. Deep foot infections in patients with diabetes and foot ulcer An entity with different characteristics, tteatments, and prognosis. J Diabetes Complications 1999 13 254-263. 

Diabetic wound is a complication of diabetes mellitus which is characterised by the slow healing of normal wounds specially produced at the body extremities leading to diabetic foot ulceration etc. It leads to approximately 20% cases of hospitalisation, amputations, morbidity and 50% of non-traumatic lower limb amputations [10, 11]. Diabetic wounds are accelerated by the microorganisms like Staphyloccocus aureus. Pseudomonas, Streptococci etc. [11]. Medicinal plants have been extensively used for thousands of years to cure ailments like diabetes, blood pressure, infection etc. Herbal, Unani, Chinese, traditional or folklore all state the beneficial effects of such plants [12, 13]. 

Disorders of the foot are among the most common complications of diabetes, accounting for as many as 20% of all hospitalizations in diabetic patients at an annual cost of 200 to 350 million. Approximately 25% of diabetic patients experience significant soft tissue infection at some time during the course of their lifetime. Approximately 55,000 lower extremity amputations, often sequelae of uncontrolled infection, are performed each year on diabetic patients this represents 50% of all nontraumatic amputations in the United States. Between 10% and 20% of diabetics will undergo additional surgery or amputation of a second limb within 12 months of the initial amputation. By 5 years, this increases to 25% to 50%, with death reported in as much as two-thirds of patients. ... 

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