Clinicopathological study and management of diabetic foot

Abstract

Background: The main objectives were to study the bacteriology, pathophysiology of diabetic foot, various limb salvage procedures and outcome, different treatment modalities and newer techniques wherever applicable to prevent complications and to minimise the progression of occurred complication.

Methods: 50 patients admitted with diabetic foot presenting with lesions of foot were selected for the study and were managed conservatively and surgical interventions if needed.

Results: Majority of the patients in the study revealed history of trauma preceding the foot complications and the chances of injury increased in these patients because of increased incidence of ischemia, neuropathy and infection. 15 patients in this study had neuropathy, 8 patients had ischemia and all cases were culture positive. 16 cases were managed by daily dressing and wound debridement, and slough excision. 9 patients were treated with Split skin graft, 6 patients with incision and drainage (IandD) for abscess and fasciotomy, 10 cases with disarticulation, below knee amputation (BKA) was done in 4 cases and above knee amputation (AKA) in 5 cases.

Conclusions: Males are almost four times more affected than females, duration of diabetes varied from 1 year to 22 years and many patients were diagnosed post admission, trivial trauma of some kind was the initiating factor in nearly half of the cases, commonest presenting lesion was Ulcer 52%, conservative treatment consisting of control of diabetes was effective. Wound debridement, slough excision followed by dressing resulted in healing in some cases. Split skin grafts, Disarticulation, below knee amputation and above knee amputations were the other modes treatment.