diabetic foot

Headline
History Is the patient septic?
- How long the ulcer has been a problem
- Treatment so far, including antibiotics
- Wound swabs and MCS results if known
- Presence of pain
- Systemic features
- Smoking status
- Glycaemic control
- Compliance with treatment
- Look for previous culture results, if available
Examination TAKE THE BANDAGES OFF.
At least 2 of:
- local swelling/induration
- erythema
- local tenderness/pain
- local warmth
- purulent discharge
Diagnostic investigations clinical o/e is more important than wound swab
Immediate management - Impending septic doom
- Red flags: Acute limb ischaemia, deep seated soft tissue/bone infection, gangrene
- Swab it!
- Immediate antibiotic if red flags/obviously septic
Ongoing management - Prophylaxis not recommended

#endocrine #vascular

Diabetes mellitus, Diabetes mellitus diagnostic criteria, Oral antidiabetic drugs

a pretty good infographic: https://www.bmj.com/content/359/bmj.j5064/infographic-0
https://www.rcemlearning.co.uk/foamed/the-diabetic-foot/
https://www.nice.org.uk/guidance/ng19 → see visual summary