Foot infections can be difficult problems for physicians to treat because of the biomechanical complexities of the extremity and the underlying circumstances that cause the infections. With the notable exception of patients without diabetes, peripheral vascular disease (PVD), or other metabolic conditions, these infections typically follow a traumatic event or tissue loss with contamination by foreign materials, colonization by bacteria, or both. However, the more common presentation is that of a patient whose health is compromised with a metabolic or peripheral vascular defect that complicates optimal successful treatment.
Treatment strategies for foot infections have been changing and evolving as a result of pharmacologic and technical breakthroughs. Plastic and reconstructive techniques for limb salvage have altered the course of treatment for foot infections, with the goals of functional restoration and a major decrease in amputation rates.
Physicians need to be aware of the many different types of foot infections that exist. Some foot infections are very simple, but others are quite complex, and no two are exactly alike. They are categorized into three groups: soft-tissue foot infections, bone infections in the foot and diabetic foot infections. Foot infections in diabetic patients can be unpredictable and are typically polymicrobial.
Soft-tissue infections in the foot consist of any infectious process affecting the skin, subcutaneous tissue, adipose tissue, superficial or deep fascia, ligaments, tendons, joints or joint capsules. Considering that there are more than 20 joints, 44 tendons, approximately 100 ligaments, four major compartments, and numerous fascial planes in the normal foot, one can redily appreciate the potential for complex problems.