Abstract

Background data: Saving an infected diabetic foot has been a significant challenge throughout medical history. The high amputation rates among diabetes patients in various countries confirm this reality. Additionally, microbial resistance to antibiotics makes this syndrome increasingly difficult to treat, severely impacting the quality of life for diabetics. Poorly controlled diabetes over the years causes significant damage to the entire circulatory system. When poor peripheral blood perfusion is associated with an infected diabetic foot ulcer, the chances of saving the foot decrease even further.

Objective: Drastically reduce the number of amputations in diabetic patients.

Materials and methods: To address this challenge, we created the Tardivo Algorithm, an easy-to-apply tool that identifies and classifies the diabetic foot, assigning a risk score and guiding the best clinical or surgical management.

Most cases that arrive at healthcare facilities already present some degree of infection. In these situations, photodynamic therapy plays a fundamental role in treatment, combating localized infection in ulcers, both superficial and deep, and eliminating the development of resistance. Additionally, this therapy treats osteomyelitis and often restores the bone tissue itself, avoiding major surgical debridement. Generally, treatment is performed on an outpatient basis.

Results: Published studies show that the Tardivo algorithm is very effective to cure diabetic feet. 85.5% of the diabetes patients with scores equal to or smaller than 12 presented avoided amputation. This method was evaluated and validated by the IWGDF, Venezuela, and Indonesia. Other publications demonstrate excellent results with the use of photodynamic therapy, not only in Brazil but also in Italy and China, where the method is considered promising.

Conclusion: The Tardivo Protocol prevented rescue in 85% of diabetic feet. The most important aspect is the improvement in the quality of life for these patients and their families.