Publication:

Diabetic foot ulcer: a clinical study

Background Diabetic foot ulcer is one of the common presentations of diabetic foot. The diabetic foot may be defined as a group of syndromes in which neuropathy, ischemia and infection lead to tissue breakdown, resultingin morbidity and possible amputation (World Health Organization, 1995) According to the diabetes atlas 2013 published by the International Diabetes Federation, the number of people with diabetes in India currently is 65.1million, which is expected to rise to 142.7 million by 2035. The objective of the present study was to evaluate the various presentations of diabetic foot ulcer like, resistant deep infections, ulcer with cellulitis, severe ischemia leading on to gangrene and to study percentage of surgical intervention like debridement, minor/major amputation.

Methods 60 patients of diabetic foot ulcer admitted in the department of general surgery at Guwahati Medical College, Guwahati during the period of August 2014 to August 2015.

Results The highest number of patients was seen in the age group of 56-65 years. The male to female ratio was approximately 1.4:1. Surgical complications are more common in men commonest presenting lesion was ulcers. Commonest site of lesion was toes. Trivial trauma is the initiating factor in about 68% of the cases. Most of the patients had history of diabetes mellitus between 6 to 10 years. Most common microorganisms grown from culture taken from the lesion was Staphylococcus aureus. Conservative treatment consists of control of diabetes with human insulin along with antibiotics along and simple dressing, wound debridement, slough excision, followed by dressing. Split skin grafting, disarticulation, bellow knee amputation, and above knee amputation, were the other modes of treatment. There was no mortality in present study.

Conclusions Management of the surgical patient with diabetes should be based on knowledge of the path physiology of diabetes and on an assessment of its chronic complications.