Publication:

Clinical study, management of diabetic foot and its complications

Background Diabetic foot infections are frequently polymicrobial. Hyperglycemia, impaired immunologic responses, neuropathy and peripheral arterial disease are the major predisposing factors leading to limb-threatening diabetic foot infections. The aim of the study was to study the benefit and outcome of the different treatment modalities for the diabetic foot.

Methods This study was conducted comprising 100 patients with diabetic foot in the department of general surgery at Rajiv Gandhi government general hospital, MMC from January 2019 to June 2020, over 12 months. Data were collected by detailed history, clinical examination, wound or ulcer and were recorded in the pre-designed proforma. Wagner’s classification, examination findings, blood investigations, renal function test, a swab of the wound, X-ray and treatment provided were collected.

Results Commonest presenting lesion was ulcers (44%), followed by gangrene (24%) and cellulitis (20%). The commonest site of the lesion was the dorsum of the foot (32%), followed by forefoot (28%) and toes (22%). Trivial trauma is the initiating factor in more than half of the cases. More than half of the patients, 82% had an infection. The most common microorganism grown from culture was Staphylococcus aureus (30%).

Conclusions Diabetic patients at risk for foot lesions must be educated about risk factors. The multidisciplinary team approach diabetic foot disorders has been demonstrated as the optimal method to achieve favorable rates of limb salvage in a high-risk diabetic patient. Infection in a diabetic foot is potentially limb-threatening and always requires urgent diagnostic and therapeutic attention.