Diabetic food syndrome. Chronic nonhealing wounds - an important clinical problem

Abstract

The European Wound Association, European Working Group on the Diabetic Foot and Polish Diabetology Society established the guidelines for the diagnosis and treatment of diabetic foot. Despite the growth of our knowledge of wounds and new ways of treatment some wounds remain unhealed fulfilling the criteria of a chronic wound. Wound infection is the most important factor delaying healing process and placing the patient at increased risk of lower limb amputation. The present paper reviews factors leading to wound infection, mechanisms of the pathogenicity of bacterial strains and types of bacteria-host interactions, clinical manifestations of the infected diabetic foot and clinical signs to assess the severity of infection. The reliability of wound culture results and use of topical antibiotic treatment are still controversial issues. In contrast, silver salts and iodine containing antiseptic dressings appear to be of unquestionable value. The paper provides also general principles of antibacterial treatment.