Acute attack of diabetic foot, rationale of a case

Abstract

SUMMARY: a 59-year-old male patient with type 2 diabetes mellitus and a history of resolved diabetic podopathy in the left foot currently presents Wagner II Diabetic Podopathy (PD) in the right foot. Although an aggressive surgical approach was required, this could not be performed for reasons beyond the control of the health team. Instead, a multidisciplinary outpatient treatment was chosen, which included empirical antibiotic therapy, periodic dressings and surgical debridement, using hydrogel dressings and dialkyl carbamoyl chloride (DDC). After 18 weeks, complete healing of the ulcer was achieved.
Periodic assessments were carried out focusing on the extent of the lesion, inflammatory signs, pain and infection during dressings. Antibiotic treatment was initially empirical and then adjusted according to cultures and antibiograms, with a strong emphasis on metabolic control. The patient was evaluated by a multidisciplinary team that included primary care physicians, orthopedists, and endocrinologists.
CASE DISCUSSION: this case highlights the importance of early and aggressive management of PD, as well as strict metabolic control. Surgical debridement and targeted antibiotic therapy were crucial for treatment success.
CONCLUSIONS: close follow-up of these patients and education for them and their families is recommended in order to prevent recurrences and improve quality of life.