From the Guidelines
The person with a foot injury due to a knife cut, presenting with swelling, redness, and warmth, should seek immediate medical attention at an emergency room or urgent care center. This situation requires prompt evaluation and treatment by a healthcare professional to prevent potential complications such as spreading infection, tissue damage, or systemic infection. The symptoms described suggest a possible infection, which could be serious, especially considering the mechanism of injury [ 1 ]. A medical professional will likely clean the wound, assess for damage to deeper structures, possibly order imaging, and prescribe appropriate antibiotics if infection is present, as guided by recommendations for managing diabetic foot infections, which emphasize the importance of assessing the severity of infection and selecting an empiric antibiotic regimen based on this severity and the likely etiologic agent(s) [ 1 ]. They may also provide tetanus prophylaxis if needed. While waiting for medical care, the person should:
- Elevate the foot to reduce swelling
- Avoid putting weight on the foot to prevent further injury
- Gently clean the visible wound with clean water, but should not delay seeking professional medical attention. It's crucial to note that self-treatment is not appropriate for this situation, as delayed or inadequate treatment could lead to severe consequences, including morbidity and mortality [ 1 ]. The healthcare professional will determine the best course of treatment, which may include antibiotic therapy, wound care, and possibly further interventions to ensure the best outcome in terms of morbidity, mortality, and quality of life [ 1 ].
From the Research
Initial Assessment and Treatment
- The patient's foot injury due to a knife cut, characterized by swelling, redness, and warmth to touch, suggests a potential infection and requires prompt attention 2.
- The treatment for major wounds, such as this one, involves early aggressive debridement, copious irrigation, and skeletal stabilization with early coverage of skin defects 2.
- Local and systemic antibiotics are adjunctive to debridement to prevent infection, and prompt recognition and release of compartment syndrome of the foot are extremely important 2.
Wound Preparation and Infection Prevention
- The use of effective preoperative preparation solution is an important step in limiting surgical wound contamination and preventing infection, particularly in foot and ankle surgery 3.
- ChloraPrep, a combination of chlorhexidine and alcohol, has been shown to be the most effective agent for eliminating bacteria from the halluces and the toes 3.
- In the emergency department, the evaluation and treatment of ankle and foot injuries, including the administration of antibiotics, are crucial in preventing infection and promoting healing 4.
Antibiotic Treatment
- The use of antibiotics in open fractures of the lower extremity, including foot injuries, is essential in preventing infectious complications 5.
- However, the addition of an aminoglycoside to a cephalosporin may not be necessary and can increase the risk of acute kidney injury, suggesting that cephalosporins alone may be sufficient for prophylaxis in Grade III open fractures of the lower extremity 5.