Introduction
Assessment of diabetic foot wounds for infection is a fundamental part of wound management alongside pressure relief and vascular state. Unidentified or delayed identification of infection can have disastrous consequences for the patient.
“The complication of diabetes that patients fear most is leg amputation, and infection is often the final pathway that leads to this tragic, if often preventable, outcome.” (1)
However infection is often difficult to identify as it has been shown that up to 50% of patients with limb threatening infection do not show systemic signs or symptoms (1). Initial evaluation of wound state is therefore essential as it can determine the outcome of the wound and also potentially the outcome of the limb and the patient as a whole.
Assessment of wound infection is multifaceted, incorporating clinical assessment and diagnostic tests, with the latter having little value if not used alongside reference to the patient. The following sections will look at important considerations the clinician should take when identifying whether a wound is infected:
- Patient history
- Clinical examination
- Arterial assessment
- Site of ulcer
- Debridement
- Probing wounds
- Osteomyelitis
- Microbiological testing
- Colonisation
- Radiological imaging
- Wound classification
