DIABETIC FOOT. A LITERATURE REVIEW (Atena Editora)

Abstract

Goal: To review the literature on the advances in the knowledge of the diabetic foot, its treatment, complications and, above all, the therapeutic options for the diabetic foot based on the most frequent types of bacteria and their behavior before antibiotics. Materials: A review of the most relevant articles on the subject published in recent years, obtained by a search in the MEDLINE and GOOGLE ACADEMICO databases, was made. Results: The diabetic foot is a clinical alteration of neuropathic etiopathogenesis and induced by sustained hyperglycemia, in which with or without coexistence of ischemia, and prior traumatic trigger, produces injury and/or ulceration of the foot; It occurs in 1 to 4% of the general population or 10 to 20% of diabetic patients that has precipitating, triggering, and aggravating factors. Excelling in the triggering factors in improper use of shoes and the lack of self-care of the feet. The main classifications for diabetic foot are the Meggit-Wagner and Texas classification. There are well-established criteria for hospital admission of these patients based on the severity of the wound, the evolutionary state of the disease, its comorbidities, and the personal and social condition of the patient. The great variability of bacteria that infects the diabetic foot is evidenced, as well as their different behaviors when faced with antibiotics, which makes it difficult to establish an adequate initial empirical treatment. Conclusion: The multidisciplinary treatment of the disease, the wounds and recommending an opportune diagnosis, the early initiation of an adequate empirical antibiotic scheme based on the frequency and local bacterial sensitivity, as a fundamental pillar when defining the antibiotic scheme to be used.