Diagnostic and Therapeutic Characteristics in the Approach of Diabetic Foot in the Elderly.

Abstract

This article systematically evaluates the most used diagnostic measures for the management of diabetic foot in the elderly, the decision making in the surgical approach, the tertiary prevention of the disease and the microbiological behavior. The initial diagnostic study for musculoskeletal infections and alterations is conventional radiography (sensitivity 40-75%, specificity 60-90%), computed tomography is more useful in the approach to chronic infection, assessing bone abductions and deformities. Magnetic resonance (sensitivity 100%, specificity 40%) is useful to assess the formation of abscesses and bone compromises.Decision-making in the surgical approach is due to sensory, motor or mixed neuropathy; which predispose to ulcers, fractures, deformities and fissures of the skin; lesions that are overinfected and must be operated on. Infections in elderly people with diabetic foot show that Staphylococcus Aureus is the main pathogen causing osteomyelitis. Beta-hemolytic Streptococci / S. Aureus, in patients with cellulitis, without open cutaneous wound, except in repeated mono microbial cultures, immunosuppressed patients or ulcers that do not respond to treatments. The diagnosis and treatment of diabetic foot continues to be a challenge for the health system; it is important that health institutions form interdisciplinary groups aimed at improving patient conditions, who must perform timely, adequate treatment, with routine monitoring and follow-up; using diagnostic methods throughout the course of the disease in order to reduce the need for amputations of the extremities.Keywords: Therapeutic approach, Diabetic Foot, osteomyelitis.