Social-behavioral, clinical and anesthetic concern associated with diabetic foot amputation in a Tertiary Care Institute of North India

Abstract

Background and Aim: India has become the world capital of diabetes and its associated complications. Patients with diabetic foot lesions presenting for amputation suffer from various socio-behavioral, psychological and economic constraints, which have an impact on the care providers of those affected as well. The aim of this study was to evaluate these socio-behavioral and anesthetic concerns in those undergoing amputation so as to draw an insight to this curb the menace of diabetes. Materials and Methods: The study included 171 patients in the age group 29-78 years of either sex who underwent either amputation or debridement, followed by amputation. The clinical status was observed and duly recorded in the performa meant for the study. The socio-behavioral aspects related to diabetic foot were recorded by interview method form patients and their relatives. Results: A higher occurrence of diabetic foot morbidities was found in males (152) than in females (19) with a mean age of 52.64 years at the time of presentation in our study. Socio-behavioral factors such as low literacy levels, treatment by quacks, inadequate foot care and habit of walking barefoot, lack of physician follow-up and association of concomitant risk factors such as smoking and alcoholism and co-morbidities were important triggers for diabetic foot morbidities and subsequent amputation. These also had psychological impacts on its sufferers. Neuropathy was the main culprit accounting for 88.89% cases, while neuropathy accounted for 11.11% cases. Conclusion: Diabetic foot patients undergoing amputation require multidisciplinary management and anesthesiologist as well intensivist can play a pivotal role in psycho-social and behavioral therapy of these patients.