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DOI: DOI:https://dx.doi.org/10.21088/nijs.0976.4747.9418.7

Abstract

Introduction: The prevalence of Diabetic patients in India is 9% of total population [1]. The risk development of foot ulcer in diabetics during their lifetime is 25% [2]. More than 20% diabetics get operated for lower extremity amputation. The present study was aimed to study treatment of foot lesions indiabetics in patients presenting in Pravara Rural Hospital, Loni.

Materials and Methods: This prospective cross sectional study was undertaken in 50 patients carried out over a period of 2 years. Patients, irrespective of their age and gender, admitted in the inpatient department of surgery with Diabetes mellitus having foot problem and consenting for taking part in the study were included. Treatment and its outcome were recorded for all patients.

Results: Most patients present with diabetic foot lesion were in 7th decade of life. Females were more commonly affected with male to female ratio 1:1.5. Ulcer was the common lesion seen here which was present in 24 (48%) patients while abscess seen in 3 (6%) patients, was the least common lesion. Staphylococcus aureus was the commonest grown organism form the pus sample of foot lesions. On staging the patients according to Wagner staging, most of the patients belonged to stage III (23) and IV (14). Maximum patients revealed decrease in insulin requirement after control of infection. In this study 23 (46%) patients out of 50 with diabetic foot categorized with Wagner’s grade III, and Wagner stage III, IV, V had higher incidents of amputations 46% of patients with Wagner stage III had different kinds of amputations and 14 (28%) of patients with stage IV needed amputations . Patients with Wagner’s stage V needed major amputations like below knee amputations and above knee amputations, one each. Most patients 41 (82%) had recovered within four weeks however 9  patients took more than four weeks of recovery.

Conclusion: Wagner stage is an important factor determining the treatment of diabetic foot.This study also revealed that patients with diabetic foot lesion treated conservatively with higher antibiotics debridement and split skin graft might reduce chances of amputations.

Keywords: Diabetic Foot; Wagner Staging; Staphylococcus Aureus; Amputation; Debridement.

 

Corresponding Author : Satish Sonawane, Associate Professor, Department of Surgery, Rural Medical College, Pravara Institute of Medical sciences (DU), Loni, Ahmednagar, Maharashtra 413736, India.