Diabetic foot is a common serious complication in patients with diabetes mellitus, which is related to many factors such as peripheral neuropathy, vascular disease and infection caused by diabetes mellitus. Anaerobic infection is particularly common in diabetic foot, and often leads to complex conditions and difficult treatment. This article will discuss the clinical diagnosis and treatment of diabetic foot with anaerobic infection in detail.
1. Clinical diagnosis 1. Medical history and clinical signs
. Patients with
diabetic foot usually have a long history of diabetes and poor blood sugar control. When foot ulcers, pain, redness and other symptoms occur, the possibility of co-infection should be considered. Anaerobic infection is often manifested by foul odor of the wound, dark or black secretion, skin necrosis around the wound, etc. 2. Physical examination
Through a physical examination, the doctor can observe the size, depth, color of the wound and the condition of the surrounding tissue. For patients suspected of anaerobic infection, special attention should be paid to whether there is necrotic tissue and gas production (such as gas gangrene) in the wound. 3. Laboratory examination
Laboratory tests included the detection of blood routine, erythrocyte sedimentation rate, C-reactive protein and other inflammatory indicators, as well as the bacterial culture of wound secretion. For anaerobic infection, special culture medium should be used, and colony morphology, Gram staining and other characteristics should be observed. 4. Imaging examination
Imaging examinations such as X-ray, CT and MRI are helpful to evaluate the condition of foot bones, muscles and blood vessels. In patients with suspected osteomyelitis, a bone scan or MRI should be performed to confirm the diagnosis.
2. Treatment 1. Control blood sugar
Controlling blood sugar is the basis of treating diabetic foot. By adjusting diet, using hypoglycemic drugs or insulin, blood sugar can be controlled within the ideal range, which can help reduce the occurrence and aggravation of infection. 2. Anti-infective treatment
For anaerobic infections, sensitive antibiotics should be selected for treatment. Commonly used antibiotics include penicillins, lincomycins, nitroimidazoles and so on. The most appropriate antibiotics should be selected according to the results of bacterial culture and drug sensitivity test to avoid the abuse of antibiotics leading to drug resistance. 3. Debridement and dressing
change
For diabetic foot patients with anaerobic infection, debridement should be carried out in time to remove necrotic tissue, pus and foreign bodies. Dressing should be changed regularly after debridement to keep the wound clean and dry and promote wound healing. 4. Surgical treatment
For patients with severe disease, such as osteomyelitis and gas gangrene, surgical treatment should be considered. Surgical methods include incision and drainage, amputation, etc. Appropriate surgical methods should be selected according to the specific conditions of patients. 5. Supportive treatment
Supportive treatment includes nutritional support, pain management and psychological support. By giving patients adequate nutritional support to enhance the patient’s immunity; through pain management to alleviate the pain of patients; through psychological support to help patients build confidence to overcome the disease.
3. Prevention
The key to
prevent diabetic foot infection with anaerobic bacteria is to control blood sugar, improve foot blood circulation, and keep feet clean and dry. Diabetic patients should have regular foot examinations to detect and deal with foot problems in time. For foot ulcers and other lesions, debridement and dressing change should be carried out as soon as possible to avoid the occurrence and aggravation of infection.
To sum up, diabetic foot with anaerobic infection is a serious complication, and its clinical diagnosis and treatment need to consider the patient’s medical history, clinical signs, laboratory results and imaging examination and other factors. Comprehensive measures such as blood glucose control, anti-infective treatment, debridement and dressing change, surgical treatment and supportive treatment can effectively improve the therapeutic effect and reduce the amputation rate and mortality rate. At the same time, strengthening the implementation of preventive measure is of great significance for reducing the incidence of anaerobic infection in diabetic foot.
Diabetic foot
