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BONE DEFECTS CAUSED BY DIABETIC FOOT INFECTIONS

Foot infections in diabetic patients usually begin in a skin ulceration and 25% will spread from the skin to deeper subcutaneous tissues and/or bone. Up to half of those who have a foot infection will have another within a few years.

About 10%-30% of diabetic patients with a foot ulcer will eventually progress to an amputation, which may be minor (i.e. foot sparing) or major. An infected foot ulcer precedes 60% of amputations, making infection perhaps the most important proximate cause of this tragic outcome (Lipsky et al, 2004).

Foot ulcers can occur in anyone, but are more likely to become infected in people with diabetes because they suffer from peripheral diabetic neuropathy and reduced blood flow to their feet.

Neuropathy means that the nerves that usually relay pain to the brain are not functioning well - it is thought this may be caused by high blood sugar levels that can cause nerve damage. As a result, a person with diabetes can walk on an ulcer without being aware of it.

In addition, poor blood flow to the feet means that the ulcer does not heal as fast as it otherwise would, and is compounded by the fact that pressure is continually being applied to the wound. As a result one quarter of ulcers progress into the deeper tissues and/or bone in diabetic patients.

If your physician deems the infection to be mild, it may be treatable with antibiotics in an outpatient setting. If the infection is moderate, antibiotics in hospital may be required, and if the infection has reached the bone (osteomyelitis) it will need to be treated surgically, by removal of dead tissue and bone (debridement) and filling of the resultant void. CERAMENT®|G and/or CERAMENT® V can be used for this void, and offer a high local concentration of antibiotic to protect bone and soft tissue healing, and remodel into bone, aiding the restoration of normal biomechanics.

 

REFERENCES

Lipsky BA. Medical Treatment of Diabetic Foot Infections. CID 2004:39 (Suppl 2), S104–14

Lipsky BA. Osteomyelitis of the Foot in Diabetic Patients CID 1997;25 (December)