Publication:

Predictive risk factors for lower limb amputations in patients with diabetic foot ulcer in correlation with Wagner’s grading

Background Lower extremity amputation in diabetic patients results in high morbidity causing poor quality of life despite high medical expenses. A correlate of risk factors with Wagner‘s grading of foot ulcers and their improvement with multidisciplinary team approach would form a basis for preventive diabetic foot care guidelines in health care policy. Objectives of current study were to assess the risk factors and role of multidisciplinary team approach in patients undergoing lower extremity amputations with diabetic footulcer with different Wagner‘s grading.

Methods Prospective data of diabetic patients above eighteen years with foot ulcers admitted in departments of general surgery/general medicine at Vydehi Institute of medical sciences and research centre, between October 2017 to October 2019 were included. Multi-disciplinary treatment approach was adopted and treated accordingly. Patients were followed up for three months to reassess the risk factors for lower extremity amputation and correlated with Wagner‘s grading system and analyzed using descriptive statistical analysis, SPSS-21.

Results fifty patients with Wagner’s grade 1-4 of which forty four (88%) males and six (12%) females. Four (8%) of the patients underwent major limb amputation. 18% underwent minor amputation and 16% SSG. 54% were grade 3,4 on day 1 and 24% patients were grade 3, 4 and 5 after 3 months of follow up (p=0.034).

Conclusions Clinical assessment of diabetic foot ulcer and identification of risk factors for the nonhealing predicts the favourable outcome in the management of diabetic foot combined with multi-disciplinary team approach strategy.