1130_Peters.pdf

《1130_Peters.pdf》由会员分享，可在线阅读，更多相关《1130_Peters.pdf（39页珍藏版）》请在三个皮匠报告上搜索。

1、Management of Infection:What Else Matters?Dr.EJG Peters Internist Infectious Diseases and Acute MedicineSpecialistConflicts of Interest No relevant financial disclosures Member guideline committee diabetic foot International Working Group Diabetic Foot Infectious Diseases Society of America Dutch di

2、abetic foot guidelines Wound Healing Society Wound Healing Foundation Research funding Senior Research Fellow Grant:Dutch Diabetes Research FoundationGoals and take home message Only treat infected wounds Know your local resistance profile Only treat the pathogen Not much proof for topical antimicro

3、bials Do not overuse antibiotics Do not overuse antiseptics Consider non-antimicrobial therapies surgeryThe basics Peripheral artery disease Biomechanical off loading Wound care Glycemic control Cardiovascular risk managementEWMA,J Wound Management,2022Sebastian Probst,SwitzerlandJan Apelqvist,Swede

4、nThomas Bjarnsholt,DenmarkBenjamin Lipsky,USAKaren Ousey,UKEdgar Peters,the NetherlandsHow to get rid of microorganisms?MethodChemicalPhysicalMechanicalBiologicalChemical:antimicrobialsAntibioticAntisepticDisinfectantSanitisation12http:/ review topical antibiotics DFISkin soft tissue infection witho

5、ut osteomyelitis:RCT minor amputation,gentamicin collagen sponge vs SOC:faster wound healing RCT pexiganan vs ofloxacin in mildly infected wounds:no difference RCT gentamicin sponge vs SOC mildly infected wounds:no difference 2 RCTs genta and syst Abx vs syst Abx moderate-severe infx:no differenceSo

6、ldevila-Boixader,Antibiotics 2023,12,124Systematic review topical antiseptics in DFI 7 studies identified RCT Superoxidised water vs SOC:less erythema and exsudate Open label RCT povidone iodine vs superoxidised water:longer systemic Abx Open label RCT superoxidised water vs saline+levofloxacin vs s