Abstract
Objective: To audit the management of diabetic septic foot [DSF] lesions in Omdurman Teaching Hospital, usingWagner classification. Patients and methods: This is a retrospective study on 208 patients with DSF admitted to Omdurman Teaching Hospital, Sudan between June 2006 and May 2007. Data were analyzed manually Results: The male to female ratio was 2:1. The mean age± SD was 56 ± 12.35 year. 16.8% patients were grade 1. 33 (15.9%) patients were grade 2. grades 3, 4, 5 patients were 66 (37 %), 38 (18.3%) and 36 (17.3%) respectively. Major lower limb amputation and mortality were 19.2%, and 6.7% respectively.Conclusion: Preventive measures for patients at risk are highly needed as well early presentation isencouraged when ulcer develops in diabetic foot to avoid subsequent complications.Key words: Diabetes Mellitus, Diabetic septic foot, amputation
Highlights
The aim of this study is to evaluate the management of different diabetic septic foot lesions, according to Wagner classification; this will help us to describe the lesion we treat, to compare the outcome with others, and to identify measures to decrease morbidity and mortality due to diabetic septic foot
Non insulin dependent diabetes was found in 84% of our patients, 16% of the patients have involvement of contra lateral foot
Amputation is preceded by a foot ulcer progressing to deep gangrenous infection; most of these ulcers are caused by minor trauma, frequently as a result of poorly fitting foot wear or inadequate foot care 2
Summary
This is a retrospective study on patients with DSF admitted to Omdurman Teaching Hospital between June 2006 and May 2007. The medical records were carefully reviewed and the following informations were gathered: Age, sex, type of diabetes and its duration. Length of hospital stay and comorbidity were carefully recorded. All diabetic foot ulcers were classified and grouped according to Wagner's grouping system, in which, foot lesions are divided into six grades based on the depth of the wound and the extent of the tissue necrosis[9, 10]. The diagnosis of infection was based on the on International Working Group guidelines. This was based on the presence of purulent secretions / or at least two of the cardinal manifestations of inflammation 2, 11. Minor amputation was defined as any lower extremity amputation distal to the ankle joint. A major amputation was any lower extremity amputation through or proximal to the ankle[11]
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