Multidisciplinary Care of the Diabetic Foot Patient With Infection

The presentation of a diabetic patient with a foot ulcer is a pivotal event in the life history of that patient. The ulcer may lead to infection, local tissue death, and eventual amputation. The development of infection constitutes a foot care emergency, which requires referral to specialized foot care team within 24 hours. This team should comprise physician, podiatrist, nurse, orthotist, radiologist, vascular surgeon, and orthopedic surgeon. The development of an ulcer and subsequent infection reflects an intrinsic impairment of the integrity of body systems that has not only predisposed to an ulcer and infection but which can subsequently lead to loss of homeostasis, severe comorbidities, and eventually to the patient’s death. This may occur in the short term during the presentation of the patient with an ulcer and infection or in the follow-up years. Indeed, the 5-year mortality rate for diabetic patients with a neuropathic ulcer is higher than patients with Hodgkin’s disease, breast cancer, and prostate cancer, and the 5-year mortality rate for patients with ischemic ulcers is higher than those with colon cancer as well as Hodgkin’s disease, breast cancer, and prostate cancer. Thus, there is a high rate of comorbidity in patients with diabetes, foot ulcers, and infections associated with failure of many body systems, including