Diabetic Foot Ulcer Complications and Its Management—a Medical College-Based Descriptive Study in Odisha, an Eastern State of India

Abstract

The aim of this study was to prepare a profile of diabetic foot ulcer (DFU) complications and its management and to assess the outcome of the surgical interventions. A prospective study was carried out in 60 patients with DFU during the period of January 2009 to October 2010 to categorize them based on Meggit-Wagner system and to find out the complications, management, below knee amputation rate, and mortality rate. Majority of the patients (30 %, n = 18) presented with Wegner grade 3 DFU. Only three patients (5 %) presented with grade 0 DFU. Split skin grafting was the most frequently done intervention, comprising 29 % of the time. Below knee amputation was required in 10 % of cases and mortality rate was 12 %. Lack of awareness about diabetes mellitus and its lower limb complications, poor compliance to the treatment, poorly controlled blood sugar levels, delay in diagnosis, and late presentation to the tertiary care center are all factors which led to occurrence of DFU at an age earlier than that seen in other studies.

Management of Diabetic Foot Ulcer in a Tertiary Level Hospital-Faridpur

“…In this study, DFU was a complication seen exclusively in diabetic patients and it developed usually in the sixth and the seventh decades of life which was compatible with other studies 14,15 . It usually developed at 5-to 10years duration of diabetes mellitus.…”

“…Among the 210 patient, most of the patients presented within Wagner G-I to G-3. Debridement and split thickness skin graft were the most frequently performed surgical intervention for DFU in present and the same in other studies 14,15 . Maximum patients of G-1,2 thus saved conservatively or by minimal intervention where in G-3, 4 and 5 patients need to be amputated.…”

“…Other contributory risk factors include obesity, sedentary life style, poor glycemic control, and alcoholism. Smoking has got special attention with 3 times higher incidence in this study supported by others which may mimic the disease process 14,15 . DFU coexist with comorbidities like CKD that was shown in our study.…”

“…It usually developed at 5-to 10years duration of diabetes mellitus. The main predisposing factors were peripheral neuropathy and peripheral vascular disease 14 . Other contributory risk factors include obesity, sedentary life style, poor glycemic control, and alcoholism.…”

Recalcitrant Foot Ulceration in a Patient With Type 1 Diabetes Mellitus

“…Foot ulceration is common in people with diabetes and is associated with various complications, including infected ulceration, cellulitis, osteomyelitis, bacteremia, sepsis, gangrene, and minor and major lower limb amputations [1,2]. The prevalence of foot ulceration amongst people with diabetes is between 4% and 10%, and approximately one in four patients with diabetes develop foot ulceration during their lifetime [3].…”