Management of diabetic wounds is on identification, treatment, and prevention.
A careful physical appraisal of the diabetic patient in an exam may not be enough to indicate areas of concern. A history from the patient that indicates subclinical preludes to overt disease, such as tingling and numbness.
Pressure points, especially over bony prominences, require additional scrutiny because of possibly more serious bone infection underlying the skin.
After identifying infected areas, culturing them, identifying the responsible organism(s), the sensitivity test will indicate the best choice(s) of antibiotic(s). With on-going wound care, scrupulous follow-up with the treating physician will assure that the protocol being used and choice of antibiotics are effective. Treatment failure may indicate bacterial resistance or patient immunocompromise.
The linchpin of management and treatment is strict glycemic control, with counseling with a dietitian/nutritionist, exercise, and avoidance of alcohol to offer the best chance for glucose management success.