Infections in the diabetic foot

Minor infections of the foot in elderly diabetic patients, with associated degenerative diseases, may lead to a devastating major infection of the foot, with subsequent loss of limb or life. Understanding the spread of infection from toe to foot to leg requires some understanding of anatomy, knowledge of the nature of bacteria and the body's response to skin organisms. The role of inadequate nerve supply is still obscure. Appearance of the first `black spot' indicates that a minor break in the skin has become a major infection with a grave prognosis. Reconstruction of arteries has helped in the management of these infections. To properly manage these patients, the physician must provide longterm support and meticulous foot care. Treatment of a wound is time consuming, difficult and, unfortunately, not always successful. However, because some wounds heal and a functional foot may be the result in a few patients, the effort is worthwhile.