Prospective observational study to note the clinical outcomes and explore prognostic factors related to ulcer healing in patients with diabetic foot

Abstract

Introduction: Diabetic foot is a common clinical condition encountered by a general surgeon affecting the lower limbs more commonly causing neuropathy loss of sensation and delay in wound healing. The causes of ulcer can be venous, arterial, malignant but diabetic foot leads in morbidity and eventually mortality. Various factors affect healing of wound which will be assessed in the study Aim: An audit to look for the outcome of diabetic foot leading toneither healing or amputation or mortality. To study the factors affecting wound healing and observe the prognosis of diabetic foot like age of patient, atherosclerosis or peripheral arterial disease, haemoglobin of patient or the nutritional status Materials and Methods:Design: Prospective and observational Place of the study: Wards, intensive care units and operation theatres of the surgery department of a tertiary care hospital. Duration of the study: From March 2018 to June 2019, after obtaining Institutional Ethics Committee approval. Out of 200 patients of diabetic foot all were given primary surgery (debridement or primary amputation) along with adjuncts for those who required it on the basis of wound, only those patients requiring admission were taken into study including infected diabetic foot. Result: in the study it was found that diabetic foot ulcer is more common in 50-60 years of age group, adjunct help in making the process faster in such a way by building healthy granulation tissue and also increases the antibiotic response to infection. Among the adjunct vacuum or negative pressure wound therapy was found to be the best. PEDIS score when compared on day 30 were found to be reduced more in patients who received NPWT. So ulcer early filled with granulation tissue is prepared for early STSG thereby reducing the hospital stay.at times patient didn’t require STSG with NPWT. It also reduced the amputation rate hence helping limb salvage.