Diabetic foot limb threatening infections: Case series and management review

Abstract

Introduction and importanceLimb-threatening infections are among the most serious diabetic foot complications that can rapidly escalate into tissue necrosis. In addition, treatment delays can lead to infection progression within hours, putting the patient at high risk for amputation. Therefore, early disease identification, proper assessment, and aggressive intervention are vital for managing this complication. Case presentationThe study presents three cases with limb-threatening infections: a 55-year-old diabetic male with chronic renal disease, a 68-year-old diabetic male with hypertension and ischemic heart disease, and a 60-year-old diabetic male. Clinical discussionA combination of surgical intervention and antibiotic therapy is vital for limb and patient survival. The surgical treatment consists of drainage of pus and removal of necrotic and infected tissue, with the integration of appropriate systemic metabolic management and a multidisciplinary team approach. Once the infection is controlled, early vascular intervention is performed, followed by debridement of necrotic soft tissues, with or without revision of the amputation stump. Surgery aims to control the infection, preserve patient health, and maintain a functional limb. Thus, the surgeon must understand foot anatomy and compartments and be familiar with wound healing in diabetic patients. ConclusionDiabetic foot complications are preventable through a multidisciplinary management team approach. This management approach is effective in improving limb salvage rates. Since the prevalence of diabetic and diabetic foot infection worldwide is increasing, evidence-based guidelines, multidisciplinary teams, and institution-specific clinical processes should be implemented to guide the optimal care of this problem.