Surgical management of the infected diabetic foot

Abstract

Different types of infection occur in the diabetic foot. Mild skin and soft tissue infections can typically be treated with outpatient management. Moderate to severe infections, infected ulcers, and osteomyelitis typically require effective work-up and surgical intervention, with and end goal of an uninfected and functional foot. Emergencies, including gas gangrene and necrotizing fasciitis, require urgent and emergent surgical intervention where the limb is not always salvageable. Patient selection based on co-morbidities and patient preference should always be taken into account for surgical planning; however, in instances where infection is too great for appropriate medical and surgical reconstructive management, primary amputation should be considered.