Diabetic Foot Ulcer Etiopathogenesis And Various Treatment Modalities A Prospective Study
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Abstract
Background: Diabetic foot is a serious complication of diabetes which aggravates the patient’s condition and also having significant socioeconomic impact.
Aim: The aim of this study is to summarize the causes and pathogenetic mechanisms leading to diabetic foot, and to focus on the management of this important health issue. Increasing physicians’ awareness and hence their ability to identify the ‘‘foot at risk,’’ along with proper foot care, may prevent diabetic foot ulceration and thus reduce the risk of amputation.
Method: A total of 63 diabetic patients with foot ulcers were included in this prospective observational study conducted at Government Medical college Jammu over a period of 12 months. Diabetic patients with new foot ulcers presenting during a 12-month period had demographics and ulcer characteristics recorded at presentation. Ulcers were followed-up until an outcome was noted.
Results: The majority of ulcers were neuropathic (66.0%) and present on the forefoot (77.8%) with a median (interquartile range) area of 1.5 (0.6±4.0) cm2. Amputations were performed for 7% of ulcers; 65% healed; 16% remained unhealed and 2% of patients died. The median (95% confidence interval) time to healing was 10 (8.8±11.6) weeks. Ulcer area at presentation was greater in the amputation group compared to healed ulcers (3.9 vs. 1.2 cm2 , P < 0.0001). Ulcer area correlated with healing time (rs = 0.27, P < 0.0001) and predicted healing (P = 0.04).
Conclusions: Ulcer area, a measure of ulcer size, predicts the outcome of foot ulcers. Its inclusion into a diabetic wound classification system will make that system a better predictor of outcome.
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References
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