Swab culture vs. Tissue Sampling of Diabetic Foot Infections: Which is better? CODIFI

Congratulations to our colleagues Nelson and coworkers and our long-time SALSAmigo, Oxford’s finest, Prof. BA Lipsky– for this superb work.

Abstract

via CODIFI (Concordance In Diabetic Foot Ulcer Infection) – a cross-sectional study of wound swabbing and tissue sampling in infected diabetic foot ulcers in England – White Rose Research Online

David G. Armstrong

Dedicated to amputation prevention, wound healing, diabetic foot, biotechnology and the intersection between medical devices and consumer electronics.

4 comments

  • in diabetic foot ulcers, in principle, there is no pathogen apart from excess sugar. The only useful treatment is debridement of both feet, knee-length toes for several months. Not with a scalpel but, a chemical that can give the skin all its elasticity and total sensitivity. that’s allall

  • be caraful what you define as an infected diabetic wound. If one obtains a tissue bx and does quantitative bacteriology on the tissue removed and the count is greater that 1×10-5th bacteria then by definition it is an infected wound. ( strep and a few other bacteria break this rule) A very innocent looking diabetic wound may be infected and clinical recognition is only made by probing the wound. Although the data is not clear yet, my bets are that ultrasound will be a helpful diagnostic tool in those lesions that are deep. Look back a good 20 or 30 years at the papers of Robson, Heggers and Krizek and be enlightened. Nice thoughtful study from the Oxford group. To answer the comment made about “sugar”–one can have neuropathy caused in part by lack of glucose control but the neuropathy may remain after good control of glucose is maintained so it is not an answer that can come from the present glucose level. One can have great glucose control and an ulcer from neuropathy or other promoting factors.

  • If he were still alive today, Louis Pasteur would tell us: Do not serching anymore. There are no significant pathogenic bacteria in the DFU . You’re wasting your time. Look at Walter’s experiences for curing it

  • 1482/5000
    Yes it’s true, you can have excellent glycemic control and an ulcer can not heal. It’s normal. It all depends on the aging of our ulcer. Once the ulcer is present and the skin of the leg is sclerotic, hyperkeratinized, our ulcer will continue to advance, even if the glucose is well regulated. Because the keratinocyte that arrives on the ulcer space took a few hours to migrate from the base to the cornea and did not have time to have the differentiation to get keratohyaline. Arrived in the wound, they are empty and they are extremely hard insoluble and do not leave their place to the new production that has had time to make the difference. And it is the crust that, from time to time, one can see with the eyes on the skin. At this moment the hole formed by the ulcer becomes an exit opening for which it must remain open for several reasons. Then each crust will open again with each new hyperglicemia and each call of the wound for a new arrige of massive proliferation of keratinocytes.or each pressure when one walks .. your ulcer becomes chronic … Yes, there is high bacterial presence but, the presence of the wound comes before the presence of bacteria, and controlled bacteria does not mean that the ulcer will be cured. All studies say and experience shows us. Bacteria are not significant pathogens for BFU cures

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