Assessment of diabetic foot infections treated in palliative care unit of our hospital

İletişim adresi: Dr. Tuba Demirci Yıldırım. İzmir Tepecik Eğitim ve Araştırma Hastanesi İç Hastalıkları Kliniği, 35120 Tepecik, İzmir, Türkiye. Tel: 0506 269 72 71 e-posta: tubademirci87@mynet.com ABSTRACT Objectives: This study aims to assess the treatment administered in patients with diabetic foot infections and palliative care services in the palliative care unit of our hospital. Patients and methods: File information of nine male patients (mean age 51.37±11 years; range 38 to 66 years) treated in our hospital’s palliative care unit as of its opening date of 12 June 2013 and diagnosed as diabetic foot infection was retrospectively analyzed. Results: Patients’ mean diabetes age was 9.12±6.9 years. Four patients had previously undergone amputation due to diabetic foot infection. All patients were receiving intensive insulin therapy. Patients’ mean glycosylated hemoglobin value was 9.2±3.7, mean fasting blood glucose value was 178 mg/dL, and postprandial blood glucose value was 262 mg/dL. Primary treatments administered in patients were blood sugar regulation, palliative support, combined broad-spectrum antibiotherapy, daily wound dressing, and hyperbaric oxygen therapy. Also, diabetic patient training was prioritized. Conclusion: The treatment of diabetic foot infection requires a multidisciplinary approach. Internal medicine, orthopedics, infectious diseases clinic, and wound care services are involved in disease management. We believe that awareness trainings for diabetic patients regarding all complications of diabetes including diabetic foot are a significant part of the management of this disease.

[1]  Serkan Akçay,et al.  Diyabetik Ayak Ülserli Hastalarda Amputasyon Oranı ve Eşlik Eden Komorbiditelerin Retrospektif Analizi , 2014 .

[2]  H. Havitcioglu,et al.  Predictors of amputation in diabetics with foot ulcer: Single center experience in a large Turkish cohort , 2009, Hormones.

[3]  P. Leung,et al.  Diabetic foot ulcers--a comprehensive review. , 2007, The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland.

[4]  Barış Akıncı,et al.  Diyabetik Ayak Ülserlerinin Tanı ve Tedavisi , 2007 .

[5]  Caroline A Baan,et al.  Comorbidity in patients with diabetes mellitus: impact on medical health care utilization , 2006, BMC Health Services Research.

[6]  S. Raptis,et al.  Trends in the presentation and surgical management of the acute diabetic foot. , 2006, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[7]  Benjamin A Lipsky,et al.  Diagnosis and treatment of diabetic foot infections. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[8]  A. Boulton,et al.  The global burden of diabetic foot disease , 2005, The Lancet.

[9]  A. Boulton,et al.  Foot ulcer risk is lower in South-Asian and african-Caribbean compared with European diabetic patients in the U.K.: the North-West diabetes foot care study. , 2005, Diabetes care.

[10]  J. Apelqvist,et al.  Health-economic consequences of diabetic foot lesions. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[11]  P. Faries,et al.  The role of surgical revascularization in the management of diabetic foot wounds. , 2004, American journal of surgery.

[12]  G. Andros.  Diagnostic and therapeutic arterial interventions in the ulcerated diabetic foot , 2004, Diabetes/metabolism research and reviews.

[13]  W. Jeffcoate,et al.  Diabetic foot ulcers , 2003, The Lancet.

[14]  T. Magee,et al.  A 1 year prospective study of management and outcome of patients presenting with critical lower limb ischaemia. , 2003, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[15]  B A Cunha,et al.  Antibiotic selection for diabetic foot infections: a review. , 2000, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons.

[16]  A. Boulton,et al.  Benefits of a multidisciplinary approach in the management of recurrent diabetic foot ulceration in Lithuania: a prospective study. , 1999, Diabetes care.

[17]  M. Edmonds,et al.  Why do foot ulcers recur in diabetic patients? , 1999, Diabetic medicine : a journal of the British Diabetic Association.

[18]  D G Smith,et al.  Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings. , 1999, Diabetes care.

[19]  D. Steed.  Foundations of good ulcer care. , 1998, American journal of surgery.

[20]  Benjamin A Lipsky.  Osteomyelitis of the foot in diabetic patients. , 1997, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[21]  W. Rayburn.  Diagnosis and classification of diabetes mellitus: highlights from the American Diabetes Association. , 1997, The Journal of reproductive medicine.