EPIDEMIOLOGY AND OUTCOME IN PATIENTS OF DIABETIC FOOT

Authors

  • M. Naeem Ashraf
  • Khalil -Ur- Rehman
  • Kamran Ishaque Malik
  • Ghulam Sabir Iqbal

Abstract

Background: The aim of study was detailed analysis of the presentation of diabetic foot ulcers,characteristics and predictors of outcome (incidence of amputation in neuropathic, ischemic, neuroischemic) in patients presenting with diabetic foot at our hospital. Methods: This prospective analyticstudy was conducted from January 2009–August 2010 at POF Hospital Wah Cantt. Diabetic patientswho presented with foot ulcers were enrolled in this study. Demographics of patients along with ulcersize, type, site and Grade according to Wagner Classification were recorded. Wounds were managedwith daily dressings, nursing care and de-sloughing of necrotic tissue along with appropriate antibioticcover. Patients were followed over period until wound healed completely or a lower limb amputationperformed, the outcome noted and patient was deemed to have completed study. Results: One hundredand fifteen patients with mean age 55.46±8.23 years, both male and female were included in this study.Out of 115 patients 111 patients had Type-II diabetes while only 4 presented with Type-I. MeanDuration of diabetes was 14.61±2.17 years. With respect to underlying causes 18.3% foot ulcers wereischemic, 22.6% were neuropathic and 59% were neuro-ischemic. Median ulcer size was 74% of ulcerclassified as Wagner grade-II and III while 24% were of Grade-V. Lower limb amputation wereperformed in 25% of patients whereas limb salvage achieved in 75% of patients with wounds healed(median healing time 5 (3–10 weeks). Conclusion: Preservation of the limb function withoutendangering the patient must be a goal of treating diabetic foot. Once foot amputation is successful,rehabilitation with orthotic or prosthetic devices may allow years of a functional extremity along withpreventive measures like cessation of smoking, daily foot hygiene and foot inspection.Keywords: diabetic foot, lower limb amputation, ulcer

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Published

2011-03-01