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Inpatient Management of Diabetic Foot Disorders: A Clinical Guide

The implementation of an inpatient diabetic foot service should be the goal of all institutions that care for patients with diabetes. The objectives of this team are to prevent problems in patients while hospitalized, provide curative measures for patients admitted with diabetic foot disorders, and...

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Autores principales: Wukich, Dane K., Armstrong, David G., Attinger, Christopher E., Boulton, Andrew J.M., Burns, Patrick R., Frykberg, Robert G., Hellman, Richard, Kim, Paul J., Lipsky, Benjamin A., Pile, James C., Pinzur, Michael S., Siminerio, Linda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747877/
https://www.ncbi.nlm.nih.gov/pubmed/23970716
http://dx.doi.org/10.2337/dc12-2712
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author Wukich, Dane K.
Armstrong, David G.
Attinger, Christopher E.
Boulton, Andrew J.M.
Burns, Patrick R.
Frykberg, Robert G.
Hellman, Richard
Kim, Paul J.
Lipsky, Benjamin A.
Pile, James C.
Pinzur, Michael S.
Siminerio, Linda
author_facet Wukich, Dane K.
Armstrong, David G.
Attinger, Christopher E.
Boulton, Andrew J.M.
Burns, Patrick R.
Frykberg, Robert G.
Hellman, Richard
Kim, Paul J.
Lipsky, Benjamin A.
Pile, James C.
Pinzur, Michael S.
Siminerio, Linda
author_sort Wukich, Dane K.
collection PubMed
description The implementation of an inpatient diabetic foot service should be the goal of all institutions that care for patients with diabetes. The objectives of this team are to prevent problems in patients while hospitalized, provide curative measures for patients admitted with diabetic foot disorders, and optimize the transition from inpatient to outpatient care. Essential skills that are required for an inpatient team include the ability to stage a foot wound, assess for peripheral vascular disease, neuropathy, wound infection, and the need for debridement; appropriately culture a wound and select antibiotic therapy; provide, directly or indirectly, for optimal metabolic control; and implement effective discharge planning to prevent a recurrence. Diabetic foot ulcers may be present in patients who are admitted for nonfoot problems, and these ulcers should be evaluated by the diabetic foot team during the hospitalization. Pathways should be in place for urgent or emergent treatment of diabetic foot infections and neuropathic fractures/dislocations. Surgeons involved with these patients should have knowledge and interest in limb preservation techniques. Prevention of iatrogenic foot complications, such as pressure sores of the heel, should be a priority in patients with diabetes who are admitted for any reason: all hospitalized diabetic patients require a clinical foot exam on admission to identify risk factors such as loss of sensation or ischemia. Appropriate posthospitalization monitoring to reduce the risk of reulceration and infection should be available, which should include optimal glycemic control and correction of any fluid and electrolyte disturbances.
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spelling pubmed-37478772014-09-01 Inpatient Management of Diabetic Foot Disorders: A Clinical Guide Wukich, Dane K. Armstrong, David G. Attinger, Christopher E. Boulton, Andrew J.M. Burns, Patrick R. Frykberg, Robert G. Hellman, Richard Kim, Paul J. Lipsky, Benjamin A. Pile, James C. Pinzur, Michael S. Siminerio, Linda Diabetes Care Editorial The implementation of an inpatient diabetic foot service should be the goal of all institutions that care for patients with diabetes. The objectives of this team are to prevent problems in patients while hospitalized, provide curative measures for patients admitted with diabetic foot disorders, and optimize the transition from inpatient to outpatient care. Essential skills that are required for an inpatient team include the ability to stage a foot wound, assess for peripheral vascular disease, neuropathy, wound infection, and the need for debridement; appropriately culture a wound and select antibiotic therapy; provide, directly or indirectly, for optimal metabolic control; and implement effective discharge planning to prevent a recurrence. Diabetic foot ulcers may be present in patients who are admitted for nonfoot problems, and these ulcers should be evaluated by the diabetic foot team during the hospitalization. Pathways should be in place for urgent or emergent treatment of diabetic foot infections and neuropathic fractures/dislocations. Surgeons involved with these patients should have knowledge and interest in limb preservation techniques. Prevention of iatrogenic foot complications, such as pressure sores of the heel, should be a priority in patients with diabetes who are admitted for any reason: all hospitalized diabetic patients require a clinical foot exam on admission to identify risk factors such as loss of sensation or ischemia. Appropriate posthospitalization monitoring to reduce the risk of reulceration and infection should be available, which should include optimal glycemic control and correction of any fluid and electrolyte disturbances. American Diabetes Association 2013-09 2013-08-13 /pmc/articles/PMC3747877/ /pubmed/23970716 http://dx.doi.org/10.2337/dc12-2712 Text en © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Editorial
Wukich, Dane K.
Armstrong, David G.
Attinger, Christopher E.
Boulton, Andrew J.M.
Burns, Patrick R.
Frykberg, Robert G.
Hellman, Richard
Kim, Paul J.
Lipsky, Benjamin A.
Pile, James C.
Pinzur, Michael S.
Siminerio, Linda
Inpatient Management of Diabetic Foot Disorders: A Clinical Guide
title Inpatient Management of Diabetic Foot Disorders: A Clinical Guide
title_full Inpatient Management of Diabetic Foot Disorders: A Clinical Guide
title_fullStr Inpatient Management of Diabetic Foot Disorders: A Clinical Guide
title_full_unstemmed Inpatient Management of Diabetic Foot Disorders: A Clinical Guide
title_short Inpatient Management of Diabetic Foot Disorders: A Clinical Guide
title_sort inpatient management of diabetic foot disorders: a clinical guide
topic Editorial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747877/
https://www.ncbi.nlm.nih.gov/pubmed/23970716
http://dx.doi.org/10.2337/dc12-2712
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