Manejo terapéutico de pacientes con pie diabético grado IV y V según escala de Wagner en el Hospital General León Becerra de Milagro durante el periodo 2022-2023.

Abstract

Introduction: Diabetic foot is a chronic and frequent vascular complication in patients with type 2 diabetes mellitus; it affects physical, emotional, and psychosocial well-being, generating a significant economic burden. However, the lack of resources has led to changes in the clinical-therapeutic management of these patients in order to improve the prognosis during hospital stay. Objective: To describe the therapeutic management of patients with grade IV and V diabetic foot according to the Wagner scale at the León Becerra de Milagro General Hospital during the period 2022-2023. Methodology: This is a descriptive, cross-sectional and retrospective study. The medical records of 112 patients with grade IV and V diabetic foot according to the Wagner scale treated in the emergency area were reviewed. Results: The antibiotic regimen "clindamycin 600mg every 8 hours + metronidazole 500mg every 8 hours" is of choice in grade IV and "amikacin 500mg every 12 hours + metronidazole 500mg every 8 hours" is of choice in grade V. The most frequent therapeutic complications are surgical site infection (18.75%) in patients with grade IV and sepsis (16.96%) in patients with grade V, the latter having a high risk of mortality. Conclusions: The clindamycin or amikacin plus metronidazole regimen is the empirical antibiotic regimen of choice with an efficacy of more than 80%. Surgical resolution depends on the history and characteristics of the injury.