Khan Mohd Shahid, Jahan Noor, Khatoon Razia, Ansari Faisal Moin, Ahmad Siraj
Department of Microbiology, Integral Institute of Medical Sciences and Research, Kursi Road, Lucknow, Uttar Pradesh 226026 India.
Department of Microbiology, Hind Institute of Medical Sciences, Mau, Ataria, Sitapur, Uttar Pradesh 261303 India.
Indian J Microbiol. 2024 Dec;64(4):1401-1415. doi: 10.1007/s12088-023-01180-8. Epub 2023 Dec 29.
One of the most prominent challenges related to the management of diabetes is a diabetic foot ulcer (DFU). It has been noted that > 50% of ulcers become clinically infected in diabetic patients, and up to 15-25% of diabetic patients may acquire DFU in their lifetime. DFU treatment is complicated for immune-compromised individuals and has a low success rate. Therefore, diabetic foot care must begin as soon as possible to avoid negative outcomes such as significant social, psychological, and economic consequences, lower limb amputation, morbidity, and mortality. The information provided in this piece is crucial for assisting clinicians and patients regarding novel and cutting-edge treatments for DFU. Due to irrational recourse to antibiotics, etiological agents like bacteria and fungi are exhibiting multidrug resistance (MDR), making topical antibiotic treatments for wounds ineffective with the drugs we currently have. This review article aims to compile the various strategies presently in use for managing and treating DFUs. The piece covers topics like biofilm, diagnosis, drug resistance, multidisciplinary teamwork, debridement, dressings, offloading, negative pressure therapy, topical antibiotics, surgery, cell and gene therapy, and other cutting-edge therapies.
与糖尿病管理相关的最突出挑战之一是糖尿病足溃疡(DFU)。值得注意的是,超过50%的溃疡在糖尿病患者中会发生临床感染,高达15%-25%的糖尿病患者一生中可能会患上DFU。对于免疫功能低下的个体,DFU治疗很复杂且成功率较低。因此,糖尿病足护理必须尽早开始,以避免出现重大的社会、心理和经济后果、下肢截肢、发病率和死亡率等负面结果。本文提供的信息对于帮助临床医生和患者了解DFU的新型前沿治疗方法至关重要。由于不合理地使用抗生素,细菌和真菌等病原体正呈现多药耐药性(MDR),使得目前可用药物对伤口进行局部抗生素治疗无效。这篇综述文章旨在汇总目前用于管理和治疗DFU的各种策略。文章涵盖了生物膜、诊断、耐药性、多学科团队合作、清创、敷料、减负、负压治疗、局部抗生素、手术、细胞和基因治疗以及其他前沿疗法等主题。