Diyabetik Ayakta Anatomik Değişiklikler

Abstract

Objective: Diabetic patients are 15 times more likely to develop gangrene, requiring amputation. Most of the non-traumatic limb amputations are due to complications of diabetes. The aim of this study was to analyse the various anatomical changes occurring in patients with diabetic foot ulcers.Materials and Methods: A prospective study was carried out in 70 patients presenting to the Diabetic Clinic at a tertiary care hospi-tal in Delhi, India under the Professor and Head of Department Surgery BHDC India, regarding the site, size, nature of foot le-sion, etiology of foot lesions and culture and sensitivity patterns of the wound swabs.Results: Most common lesions were noticed to have skin and nail changes (47 patients,67.1%) in the form of corns, callosities, dry skin, fissures, hypertrophied and brittle nails.20 patients (28.5%) presented with ulcers and 3 patients (4.2%) had gangrene. 56 patients (80%) were managed by multiple wound debridements and serial dressings.11 patients (15.7%) required skin grafting for wound healing.3 patients (4.2%) required some form of amputa-tion.Conclusion: It was found that with strict diabetic control, daily dressings, surgical intervention in the form of adequate, aggressive and timely debridement and culture specific antibiotics, the diabetic foot wounds healed well. Amputation at appropriate levels should be performed as life-saving measures in severe infections to pre-vent septicaemia and lifesaving takes precedence over limb / toe saving.