Diabetic foot infections constitute a worldwide public health problem. Once a patient presents with a significant infection, the health care system, as well as the integrity of the foot, has failed. Prevention remains the most cost-effective and important aspect of care for these patients. Prevention begins with the early detection of diabetes, and tight control of hyperglycemia, to attempt to limit diabetic neuropathy. Patient and family education regarding foot care requires time and repetition. Multimodality clinics combining podiatric, vascular, and orthopaedic consultation with wound and orthotic care specialists have been shown to be effective in reducing the incidence of ulceration in a population at risk. Once an infection occurs, aggressive and often repetitive débridements, combined with appropriate antimicrobial therapy, remain the cornerstone of treatment. Further research is needed to objectively study adjunctive therapies that are both cost-effective and can improve the limb-salvage rate.
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