Infected Diabetic Ulcers Research Articles

For a patient with type 1 diabetes and a heel ulcer, could the addition of electrical stimulation to standard wound treatment improve wound healing over standard wound treatment alone?

The purpose of “Evidence in Practice” is to illustrate the literature search process to obtain evidence that can guide clinical decision making. This article is not a case report. The examination, evaluation, and intervention sections are purposely abbreviated. A 68-year-old man was referred to our facility by his family doctor for treatment of a diabetic ulcer on his left heel that had been present for 6 weeks. He had been diagnosed with type 1 diabetes mellitus at 8 years of age. Five years ago, he underwent a transtibial amputation of his right leg because of an infected diabetic ulcer on his right heel. He now uses a transtibial prosthesis and a cane for ambulation. He stated that, since his amputation, he has been diligent with his foot care, which consists of daily visual inspection (for redness, inflammation, and wounds), moisturizing following showering, and callus and nail trimming. Despite his rigorous attention to his foot, he developed an ulcer on his left heel, which has been resistant to standard wound treatment (debridement, dressing changes, and off-loading).1 He was using Lantus* (daily) and Humalog† (with meals) to control his diabetes, Accupril‡ for his hypertension, and the antibiotics Cipro§ and Amoxicillin.‖ The patient reported decreased “feeling” in his left lower extremity and was concerned about the prospect of having another amputation. He did not appear to have an active systemic infection: when asked, he said that he had no recent nausea, fever, vomiting, or fatigue. His vital signs were all within normal ranges: body temperature of 37.1°C, heart rate of 72 beats per minute, respiratory rate of 14 breaths per minute, and blood pressure of 128/78 mm Hg. The patient's body mass index was 31 kg/m2, indicating that he was overweight. Examination of the foot …

A Late Sternal Wound Infection Caused by Hematogenous Spread of Bacteria

A 56-year-old man presented with a sternotomy wound infection 6 months after coronary artery bypass grafting. The organism responsible was group B beta-hemolytic Streptococcus. This organism was simultaneously cultured from an infected diabetic ulcer on the patient's foot as well as from a total knee prosthesis. The Streptococcus apparently spread hematogenously to the sternum, an extremely rare cause of sternotomy wound infection.

Fatal pontine hemorrhage after podiatric surgery. A case report

The authors present a case of massive fatal pontine hemorrhage as a complication of hypertension in a patient treated for an infected diabetic ulcer. The podiatric physician must be aware of the risks associated with concomitant medical problems such as hypertension and ensure that proper therapeutic measures are taken to avoid the potential for catastrophic complications.

Infected Pressure and Diabetic Ulcers

Infected pressure and diabetic ulcers are encountered frequently by clinicians caring for the geriatric population. These infections are polymicrobial and are often complicated by sepsis syndrome and osteomyelitis. Together, these infections account for significant morbidity and mortality in elderly persons. A team approach to management is essential for the clinician, and efforts should focus primarily on prevention.