Clinical study and surgical management of diabetic foot: An observational study

Abstract

Background and Aim: The most frequent reason for hospitalization for patients with diabetes is foot complications, which accounts for up to 25% of all diabetic admissions. The clinical triad most commonly seen in diabetic foot ulcer is peripheral sensory neuropathy, trauma and deformity. Diabetes continues to be one of the most common underlying causes of nontraumatic lower extremity amputations (LEAs). The aim of the study was to study the benefit and outcome of the different treatment modalities for the diabetic foot.Material and Methods: This study was conducted comprising 200 patients with diabetic foot in the department of general surgery at Gujarat Adani Institute of Medical Science, Bhuj, Kutch for 10 months. Data were collected by detailed history, clinical examination, wound or ulcer and were recorded in the pre-designed proforma. Wagner’s classification, examination findings, blood investigations, renal function test, a swab of the wound, X-ray and treatment provided were collected.Results: Most of the patients had diabetes duration for about 6-10 years (28%). Out of 200 SG cases, 88 (44%) cases presented with ulcers, 40 (20%) cases with cellulitis 32 (16%) of cases abscess, 48 (24%) of cases gangrene and 8 (4%) of cases neuropathic ulcer. The most common site of lesion in the diabetic foot was the dorsum of the foot which was in about 64 patients (32%). Out of the 200 cases studied 120 patients (60%) not had a history of trauma and 80 patients (40%) not had a history of trauma.Conclusion: The commonest presenting lesion was ulcers, followed by gangrene and cellulitis. The commonest site of lesion was the dorsum of the foot followed by forefoot and toes. The most common microorganisms grown from culture taken from the lesion was S. aureus followed by Pseudomonas. Ulceration, infection, gangrene and lower extremity amputation are complications often encountered in patients with DM.