الفهرس | Only 14 pages are availabe for public view |
Abstract a major significant risk factor. (Al Kafrawy et al, 2014) Infection is usually the consequence rather than the cause of foot ulceration, but can cause substantial deterioration and delay in healing, and clinicians should consider early use of antibiotics. Infection can be divided into three categories: superficial and local, soft tissue and spreading (cellulitis), and osteomyelitis. The contribution of yeasts and dermatophytes in chronic ulceration is uncertain. Bacteria will be present irrespective of whether a wound seems clean or is covered by necrosis and debris. It can be difficult to determine whether these are harmless or the extent to which they impair healing by releasing locally acting substances. Therefore, a surface swab is insufficient to establish whether a wound is infected; microbiological results should be interpreted in relation to clinical circumstances. Without other evidence of infection, systemic antibiotics are not beneficial (Chantelau et al., 1996). With the more serious categories (cellulitis and osteomyelitis) diagnosis is mainly clinical, with imaging assistance in osteomyelitis. Soft-tissue infection is characterized by obvious inflammation if the foot is well perfused, but can be difficult to identify if the foot. |