Diabetic foot patients with small blisters, small burns, cut wounds, chapped small mouth, athlete's foot, itching, small scratches and other foot infections
are often fuse. Due to high blood sugar inhibits phagocytic ability of bacteria and make antibodies to reduce high blood sugar itself is a source of energy
of bacteria, bacteria grow rapidly in such environments, coupled with the blood vessels narrow, poor blood flow, endogenous guard ( granulocyte cells,
antibodies) can not be timely reinforcements, bacteria in the local formation of a superior force, the spread of infection and other disorders continue to
eventually eroded limbs. According to my hospital for more than 420 cases in patients with diabetic gangrene localized secretion culture revealed
Staphylococcus aureus and other bacteria accounted for 25%, Escherichia coli, Pseudomonas aeruginosa, Klebsiella about 50%, anaerobic bacteria accounted for
25 %. Prevention of infection, active treatment infections, can be achieved to save limbs and heal ulcers goals.
1, identifying infection: lower limb infection are often red, swollen, hot (local skin temperature rise), pain and dysfunction such as performance, we should
not spread the infection very early, when treatment, a better result. As early as possible to take samples of bacteria culture, specifically what kind of
bacterial infection.
Two clinical types: a failure to limb threatening infections (mild infections): <2cm of the inflammatory infiltration, superficial ulcers, not involving the
bone and joints, no severe ischemia and systemic toxicity performance; limb and life threatening infections (in the severe infection): ≥ 2cm inflammatory
infiltration, lymphatic vessel inflammation, deep ulcers, infiltration of bone and joints, accompanied by ischemia and systemic symptoms of poisoning.
Diabetic foot infections are often not accompanied by increased white blood cells, pain and fever and so on, should be carefully identified.
3, anti-bacterial treatment: ① the use of broad-spectrum antibiotics known pathogens; ② bacterial infections: alternative intravenous drip penicillin,
cephalosporin class Jiashu Bartin; ③ Staphylococcus aureus infections: the choice of vancomycin, take the test Laning, Moxifloxacin hydrochloride,
ampicillin Jia Kelin ADM, etc.; ④ gram-negative bacillus infections: Selected third-generation cephalosporins, and cefotaxime, and so on; ⑤ anaerobic
infection: metronidazole and ornidazole using intravenous drip Tinidazole injection or oral treatment; ⑥ deep fungal infections: use of amphotericin B,
ketoconazole, fluconazole, itraconazole and so on.
4, silver treatment: silver as antimicrobial therapy has a long history. The release of silver ions in the external contact with the bacterial cell wall to
prevent bacterial respiration, kill bacteria, fungi. Silver ion antimicrobial spectrum, a wide range of Gram-positive and-negative bacteria, drug-resistant
S. aureus, fungi are killing effect, rather than drug resistance and resistance, safe, non-allergic reaction, along with anti-inflammatory and promote
healing the role of silver ions through the metal protein inactivation, wound healing, wound epithelization. Sulfadiazine silver coated with currently
available to affected area twice daily.
In short, the wound healing of diabetic foot infection depends on the understanding of bacterial wound infections, an effective systemic and topical
antibiotic therapy, adequate debridement and removal of necrotic tissue, application of silver-containing materials, moist environment for wound dressings
and partial appropriate negative pressure to attract, the only way to effectively control the infection, to avoid the stumps.
