Outcomes of Lower Limb Ulcers in Diabetics vs Non Diabetics – Our Experience in a Tertiary Care Hospital

Abstract

Background: Ulcers of lower extremities are debilitating to the patient directly and also have a great impact on the economy. The present study aims to examine the outcomes of lower limb ulcers, mainly in terms of amputations and mortality in the diabetic and non-diabetic population. Research Design and Methods: A retrospective database containing 100 cases of lower limb ulcers from 2016 to 2017 were evaluated. History obtained and baseline clinical examination was done in all patients. Treatment options like debridement, fasciotomy, split-skin grafting, minor and major amputations were considered and outcomes studied. Results: Majority of the patients were from rural areas with a mean age of 52 years. Males were the predominant study subjects. The ratio of diabetics to non-diabetics is 52:48. Debridement was done in 63% of the cases, skin grafting in 13%, fasciotomy in 6%, minor amputations in 8% and major amputation in 10% of the study group. Above-knee amputation was done in 6 cases, of which only one was diabetic. 4 patients underwent below-knee amputation, of which 3 patients were diabetic. There were a total of 5 deaths, all of them being male, diabetic cases. Conclusion:Diabetes has an increased risk of mortality and morbidity in patients with lower limb ulcers and also leads to significant impairment of quality of life. An aggressive multidisciplinary approach is required to manage foot problems in such patients and also to reduce the risk of death from other comorbid conditions to save both limb and life.