Abstract
Foot infection is a leading cause of amputations in diabetic patients. An infected foot would precede about 60% of lower extremity amputations. With an increasing infection severity, there is a significant trend toward an increased risk for amputation. Identification of critical colonization is essential in order to prevent infection. However, its diagnosis is challenging unless we bear in mind the possibility and the optimal method to diagnose critical colonization is not well established. Maintenance debridement and topical application of antibiotic dressings are effective treatment for critically colonized wound. It is recommended that all patients with a severe infection and patients with a moderate infection with critical limb ischemia be hospitalized initially. Clinicians should consider urgent surgical intervention for patients presenting with clinical evidence of life or limb threatening infection. A surgeon should also evaluate any patient who has evidence of a deep-space infection or abscess. Prompt surgical debridement and antibiotic therapy are indispensable to decrease the likelihood of major amputation.