Diabetic foot is one of the severe complications of diabetes. It not only brings a huge economic burden on patients and their families, but also causes great pain to the patient themselves. Chronic ulcers are the causes of serious consequences such as amputation (toe). Data show that a quarter of people in diabetic patients have the risk of foot ulcers in their lives. Therefore, diabetic foot needs to attract everyone’s attention, and the management of diabetic foot ulcers is very important, and small problems may cause serious consequences.
Diabetic foot and diabetic foot ulcers
First of all, you need to understand the grading of diabetic foot. Table 1 is a wagner grading. The higher the score of this hierarchy, the greater the possibility of the patient’s amputation, and the lower the cure rate and improvement rate. Table 2 is a TEXAS grading, which includes evaluation of the depth of wound, infection and ischemia.
In the clinical guidelines of the diabetic foot intervention in the comprehensive diagnosis and treatment, the diabetic foot ulcer assessment has no unified standards. Generally, the ulcer area, accumulation of tissue depth, combined infection, and tissue necrosis need to be considered. The commonly used classification tables are wagner grades.
How to choose medicine for anti -infection?
Small wounds of healthy people are easy to heal, and the wounds of diabetic patients need to be specially paid attention to. If there is infection, it needs to be treated in time and correctly to avoid worsening the condition. Table 3 and Table 4 are the infection of diabetic foot wound infection in the 2016 International Diabetes Foot Working Group. Severe level of grading.
If the clinical manifestation of the infection signs requires bacterial culture and the drug sensitivity test. Before the bacterial culture and drug sensitivity report, the antibiotics need to be given. So how to use the medicine? After the patient’s clinical manifestations, biochemical indicators, imaging examination and other comprehensive evaluation infection, experience medication is used. After obtaining bacterial culture and drug sensitivity results, sensitive antibiotics are selected.
Experience suggestions: For patients with Wagner 1-2, mild infection, and good nutritional state. Patients with antibiotics before admitting are often infected with Golden Polycinius, Pymoplactacia Bacteria, etc. At this time, penicillin can be preferred; For those with diabetic foot 3-5 and medium-weight infections, such patients are relatively low when admitted to hospital for admission. Its infection is more common in infection with Gram-negative infection, such as Transformers, E. colorectal, Copper Green Singles Bacteria, etc., at this time, you can choose amino glycoside (such as amkarin, celeryinin), three -generation cephalosporin (such as cephalosporin) and carbonicone (such as ampinnon). For patients with severe infection but Yin Min reported, they can combine two antibiotics, while covering Gram -positive bacteria and Gram -negative bacteria. After the drug sensitivity report comes out, antibiotics are adjusted, and sensitive antibiotics are selected.
Timely and effective debride
Currency is a vital link in the treatment of diabetic foot. Premature and late debridement is not conducive to the normal repair process of starting and maintaining wounds. The identification and clearance of the necrotic tissue during surgical debridement, and the preservation and protection of the health organization is a key factor in determining the appearance of the debridement.
Select the appropriate debridement technology according to the creative conditions. In addition to the mechanical debridement method, you can also use ultrasonic debridement, biological debridement, enzymatic debridement, polyetan drops, and polysaccharide polysaccharides , Water gel, etc.
Ultrasonic clearance method uses the empty, emulsified and hemostatic effect of ultrasonic, and removes the wound surface and deep bacteria and fungi through the air -ification micro -shot and strong pressure in the flushing shooting. The wounds have in -depth debridement effects.
The biological debridement method is to directly place the sterile of the green head fly on the infection, and use the characteristics of the maggot to digest the necrotic tissue and the pathogen. However, there is currently no medical biomarent worm in my country, and patients have resistance to maggots.
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Enzymatic debridement, polyetan drops, and poly glycogen polyetroleum, polyetan, and hydrogel are more convenient, which can be used directly on the wound. The technical requirements are low, but compared with other debridement methods The method of hydrogel is late.
In addition, appropriate accessories can be used for diabetic foot surfaces, which can shorten the wound healing time. For more relevant content, you can go to the medical pulse guide channel to download the relevant guidelines to read and learn.