Surgical Management of Diabetic Foot Infections and Amputations

Zgonis, Thomas; Stapleton, John J.; Girard-Powell, Valerie A.; Hagino, Ryan T.

doi:10.1016/j.aorn.2008.02.014

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Volume 87, Issue 5 , Pages 935-950, May 2008

Surgical Management of Diabetic Foot Infections and Amputations

Thomas Zgonis, DPM
- Thomas Zgonis, DPM, is an assistant professor in the Department of Orthopaedics, Podiatry Division, and the director of the Reconstructive Foot and Ankle Fellowship at the University of Texas Health Science Center at San Antonio. Dr Zgonis has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.
John J. Stapleton, DPM
- John J. Stapleton, DPM, is an associate of foot and ankle surgery at VSAS Orthopaedics, Allentown, PA, and a clinical assistant professor of surgery at Penn State College of Medicine, Hershey, PA. Dr Stapleton has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.
Valerie A. Girard-Powell, RN
- Valerie A. Girard-Powell, RN, is a perioperative nurse at the University Hospital, San Antonio, TX. Ms Girard-Powell has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.
Ryan T. Hagino, MD
- Ryan T. Hagino, MD, is an associate professor in the Division of Vascular Surgery at the University of Texas Health Science Center at San Antonio. Dr Hagino has no declared affiliation that could be perceived as a potential conflict of interest in publishing this article.

ABSTRACT

THE INCIDENCE OF DIABETES with severe foot infections (eg, necrotizing fasciitis, gas gangrene, ascending cellulitis, infection with systemic toxicity or metabolic instability) has risen significantly during the past decade.

FOOT INFECTIONS are a major cause of hospitalization and subsequent lower extremity amputation among patients with diabetes mellitus who have a history of a preexisting ulceration.

SURGICAL MANAGEMENT often is required to address severe diabetic foot infections because they can be limb- or life-threatening. Critical limb ischemia, neuropathy, and an immunocompromised host, which often are associated with diabetic foot infections, complicate treatment and are associated with a poorer prognosis. AORN J 87 (May 2008) 935–946. © AORN, Inc, 2008.

indicates that continuing education contact hours are available for this activity. Earn the contact hours by reading this article and taking the examination on pages 947–948 and then completing the answer sheet and learner evaluation on pages 949–950.You also may access this article online at http://www.aornjournal.org.The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education. Ms Holm and Ms Bakewell have no declared affiliations that could be perceived as potential conflicts of interest in publishing this article.This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.AORN is provider-approved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure.