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解读糖尿病足伤口:关于分类、多重耐药性、微生物见解、管理与治疗策略以及先进诊断工具的综合综述

Deciphering Diabetic Foot Wounds: A Comprehensive Review on Classification, Multidrug Resistance, Microbial Insights, Management & Treatment Strategies, and Advanced Diagnostic Tools.

作者信息

Silvia N Susan, Velrajan Mahalakshmi

机构信息

Department of Microbiology, Madras Christian College, Chennai, Tamil Nadu, India.

出版信息

Curr Diabetes Rev. 2025;21(6):1-11. doi: 10.2174/0115733998287694240514110935.

DOI:10.2174/0115733998287694240514110935
PMID:38798205
Abstract

Diabetic foot wounds and infections pose a significant and evolving challenge in diabetes care. Diabetic wound healing has become a major global concern for a very long time. Continuous research has been conducted to increase the healing process in diabetic ulcers to the rate of amputation. Wound healing is prolonged in diabetic patients due to various conditions, such as high glucose levels, neuropathy, poor blood circulation, and prolonged inflammation around the limbs, which causes the healing to be delayed compared to normal patients. Understanding the complexity of chronic foot wounds and the management and proper treatment would lead to a decrease in the risk of amputation. The medical team all over the world is constantly researching to lower the risk. This review paper offers a compelling journey through the multifaceted world of diabetic foot wounds and infections. It underscores the urgency of understanding classification, tackling multidrug resistance, and harnessing microbial insights to revolutionize the treatment and management of diabetic foot complications. Furthermore, it unveils state-of-the-art diagnostics, heralding a brighter future in the battle against this debilitating complication of diabetes.

摘要

糖尿病足伤口和感染在糖尿病护理中构成了重大且不断演变的挑战。长期以来,糖尿病伤口愈合一直是全球主要关注的问题。人们持续开展研究,以提高糖尿病溃疡的愈合速度,降低截肢率。由于高血糖水平、神经病变、血液循环不良以及肢体周围长期炎症等多种因素,糖尿病患者的伤口愈合时间延长,与正常患者相比愈合延迟。了解慢性足部伤口的复杂性以及管理和恰当治疗方法,将降低截肢风险。世界各地的医疗团队一直在不断研究以降低该风险。这篇综述文章带领我们踏上了一段穿越糖尿病足伤口和感染多面世界的引人入胜之旅。它强调了理解分类、应对多重耐药性以及利用微生物见解来彻底改变糖尿病足并发症治疗和管理的紧迫性。此外,它还揭示了先进的诊断方法,预示着在对抗这种使人衰弱的糖尿病并发症的战斗中有着更光明的未来。

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Deciphering Diabetic Foot Wounds: A Comprehensive Review on Classification, Multidrug Resistance, Microbial Insights, Management & Treatment Strategies, and Advanced Diagnostic Tools.解读糖尿病足伤口:关于分类、多重耐药性、微生物见解、管理与治疗策略以及先进诊断工具的综合综述
Curr Diabetes Rev. 2025;21(6):1-11. doi: 10.2174/0115733998287694240514110935.
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Treatment of diabetic foot ulcers.糖尿病足溃疡的治疗。
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本文引用的文献

1
IWGDF/IDSA Guidelines on the Diagnosis and Treatment of Diabetes-related Foot Infections (IWGDF/IDSA 2023).国际糖尿病足工作组/美国感染病学会糖尿病相关足部感染诊断与治疗指南(国际糖尿病足工作组/美国感染病学会,2023年)
Clin Infect Dis. 2023 Oct 2. doi: 10.1093/cid/ciad527.
2
Diabetic foot ulcers: Classification, risk factors and management.糖尿病足溃疡:分类、危险因素及管理
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Bacterial isolates from diabetic foot ulcers and their antimicrobial resistance profile from selected hospitals in Addis Ababa, Ethiopia.
来自埃塞俄比亚亚的斯亚贝巴选定医院的糖尿病足溃疡细菌分离株及其抗菌药物耐药谱。
Front Endocrinol (Lausanne). 2022 Aug 31;13:987487. doi: 10.3389/fendo.2022.987487. eCollection 2022.
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Pathophysiology and Molecular Imaging of Diabetic Foot Infections.糖尿病足感染的病理生理学和分子影像学。
Int J Mol Sci. 2021 Oct 26;22(21):11552. doi: 10.3390/ijms222111552.
5
Isolation and characterization of bacteria from diabetic foot ulcer: amputation, antibiotic resistance and mortality rate.糖尿病足溃疡细菌的分离与鉴定:截肢、抗生素耐药性及死亡率
Int J Diabetes Dev Ctries. 2022 Jul;42(3):529-537. doi: 10.1007/s13410-021-00997-7. Epub 2021 Sep 10.
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Addendum. 11. Microvascular Complications and Foot Care: : Diabetes Care 2021;44(Suppl. 1):S151-S167.附录11. 微血管并发症与足部护理:《糖尿病护理》2021年;44(增刊1):S151 - S167。
Diabetes Care. 2021 Sep;44(9):2186-2187. doi: 10.2337/dc21-ad09b. Epub 2021 Jun 16.
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Strategy for Treatment of Infected Diabetic Foot Ulcers.感染性糖尿病足溃疡的治疗策略。
Acc Chem Res. 2021 Mar 2;54(5):1080-1093. doi: 10.1021/acs.accounts.0c00864. Epub 2021 Feb 17.
8
Lower extremity amputations and long-term outcomes in diabetic foot ulcers: A systematic review.糖尿病足溃疡患者的下肢截肢及长期预后:一项系统评价
World J Diabetes. 2020 Sep 15;11(9):391-399. doi: 10.4239/wjd.v11.i9.391.
9
The Impact of Multidrug-Resistant Organisms on Outcomes in Patients With Diabetic Foot Infections.多重耐药菌对糖尿病足感染患者预后的影响。
Open Forum Infect Dis. 2020 May 6;7(5):ofaa161. doi: 10.1093/ofid/ofaa161. eCollection 2020 May.
10
Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update).糖尿病足感染的诊断和治疗指南(IWGDF 2019 更新)。
Diabetes Metab Res Rev. 2020 Mar;36 Suppl 1:e3280. doi: 10.1002/dmrr.3280.