Risk factors, ulcer grade and management outcome of diabetic foot ulcers in a Tropical Tertiary Care Hospital

Edo, AE; Edo, Gloria O; Ezeani, Ignatius

doi:10.4103/0300-1652.108900

Cited by 38 publications

(39 citation statements)

References 14 publications

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“…Similarly, patients who had wound infection at presentation were less likely to have had foot care education {(OR-0.444 (95% CI = 0.258-0.764) p = 0.003} and those who suffered death were less likely to have had foot care education {(OR-0.779 (95% CI = 0.410-1.480). Similar things applied to those who engaged in barefoot walking {(OR-0.512 (95% CI has been reported in similar studies around the world, where the most productive age groups are often the worst hit [16][17][18]. Our study also revealed that the males were more often the ones affected, probably because they are more active in out-door activities such as farming, mining and other high risk manual labours, as they are most of the time the breadwinners of their family.…”

Section: Discussionsupporting

confidence: 59%

“…Footcare education has long been advocated as an essential strategy of prevention of DFU, and has been widely practiced in the developed world [13][14][15]. The same cannot be said of our centres in Nigeria and the rest of the developing world, especially in Sub-Saharan Africa, where certified foot care educators and podiatrists are a rarity even in our referral centres [16][17][18]. The health system is often poorly organised, ill-equipped with poor referral system that provide incomplete coverage for the total diabetes population, majority of whom are at the understaffed primary healthcare level [18].…”

Section: Methodsmentioning

confidence: 99%

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Untitled

2019

Int J Foot Ankle

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Background: Considerable advances have been made in the field of diabetic foot care over the past 25 years in developed countries. On the contrary, diabetes foot ulceration (DFU) still remains a common diabetes related complication of substantial public health importance in sub-Saharan Africa. Diabetic foot outcome in Nigeria is reportedly poor, with high amputation and mortality rates. Proper foot care education is known to impact positively on both DFU prevention and outcome in the developed societies. However, this relationship has not been well characterised in Nigeria. Objective: To determine the relationship between diabetic foot care education, health-seeking behaviour and DFU outcome. Methods: In this one-year observational Multi-Centre Evaluation of Diabetes Foot Ulcer in Nigeria (MEDFUN) study, subjects admitted for DFU in six tertiary hospitals were evaluated for demographic and diabetes related information, ulcer characteristics and treatment modality prior to hospitalisation. Prior participation in foot care education and knowledge of proper foot care were sought while relevant laboratory tests were performed. All patients benefitted from appropriate multidisciplinary care and were followed up until discharge or death. Outcome of interest were wound healing, lower extremity amputation (LEA) and mortality. Logistics regression was used to determine the impact of foot care education on DFU outcomes.

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Section: Discussionsupporting

confidence: 59%

Section: Methodsmentioning

confidence: 99%

Untitled

2019

Int J Foot Ankle

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“…Statistically, there was low insignificant correlation between these two variables as given in table (6) and figure (3). ulcers classification were the most common prevalence 30% in ulcers of diabetic patients, and these results were compatible with other studies conducted in different countries [13][14][15], but disagree with a previous study reported that Wagner's grade 2 and 3 ulcers were the most common prevalence [16]. Grade 4 was the lowest prevalence in this study, and this contrast with other studies revealed that the grade 4 was the most common prevalence in DFU [17,18].…”

Section: Bacterial Species Of Dfu Associated With Wagner's Grades Systemcontrasting

confidence: 54%

Assessment role of phagocytic neutrophil cells among different Wagner’s grades of diabetic foot ulcers infections

Bin-Hameed¹,

Baras²

2020

Preprint

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Background: Foot ulcers complications in diabetes mellitus (DM) patients are one of the significant medical problems and an economic burden. The aim of this study is to assessment role of phagocytic neutrophil cells and its relationship with the incidence of diabetic foot ulcers (DFU) infection of diabetic patients. A total of 60 venipuncture blood samples collected from diabetes mellitus, diabetic foot ulcer patients and healthy persons as control group. 20 swabs from the DFU patients were collected and processed for culture and susceptibility test after the ulcers classified according to Wagner’s grades system. Phagocytic cells activity test was performed to determine the efficiency of phagocytic neutrophil cells in diabetic patients. Results: Gram positive bacteria were the most prevalent in the DFU patients 57.1% with statistical significant relationship between the type of bacteria and grades of Wagner’s classification followed by Gram negative bacteria in high grades of ulcers. Wagner’s ulcers grade 1 and 2 were the most prevalence in DFU patients 30%. There was a weak negative correlation between the efficiency of phagocytic neutrophil cells activity and grade ulcers classified (r = -0.323). Amikacin and ciprofloxacin were the most effective antibiotics against 90.5% and 81% of the bacterial isolates respectively, whereas ampicillin, cefepime and cefadroxil were less effective antibiotics against the bacterial isolates.Conclusion: When the grade of ulcer increased, the bacterial resistance to antibiotics increased, and this was emphasis the correlation with prevalent of Gram negative bacteria in the high grade of ulcers with high resistance of antibiotics. In contrast, the grade of ulcer increased, the efficiency of phagocytic neutrophil cells decreased.

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“…Early diagnosis and presentation to hospital for prompt treatment of DFU is capable of reducing the significant morbidity and mortality associated with this condition. [2] Early detection of peripheral neuropathy and patient's education regarding foot care and footwear is crucial in reducing risk of any injury that can lead to ulcer formation. This study has been undertaken to identify risk factors and assess the level of awareness of diabetic foot care among diabetic population reporting to our hospital.…”

Section: Introductionmentioning

confidence: 99%

A study of risk factors and foot care behavior among diabetics

Nongmaithem

Bawa²,

Pithwa

et al. 2016

J Family Med Prim Care

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Background:Diabetic foot results in considerable morbidity and mortality in developing countries and the prevalence of diabetes is expected to increase further in the next decades in these countries. Diabetic ulcers are the most common foot injuries leading to lower extremity amputation. Family physicians have a pivotal role in the prevention or early diagnosis of diabetic foot complications. Patient education regarding foot hygiene, nail care and proper footwear is crucial to reducing the risk of an injury that can lead to ulcer formation.Materials and Methods:This is a prospective study carried out from July 2013 to September 2015. Fifty patients of Diabetes with foot ulcer and two hundred without foot ulcers were examined. Risk factors and clinical profile of patients were studied which included age, gender, duration of diabetes, BMI, smoking, random BSLs history, hypertension, glycated haemoglobin levels, lipid profile, history of loss of sensation and history of amputation. MNSI questionnaire and MNSI practical assessment for neuropathy were administered to diabetic patients along with a pre-structured questionnaire regarding foot care practices.Results:In this study significant risk factors were peripheral neuropathy, peripheral vascular disease, gender, loss of sensation, duration of diabetes and smoking. MNSI questionnaire and practical assessment scores were higher in foot ulcer patients. Poor foot care practices were observed in patients with diabetic foot ulcer patients.Conclusion:Diabetic foot ulcers were more common in elderly males. Peripheral neuropathy, peripheral vascular disease, Smoking, trauma, duration of diabetes mellitus and high levels of glycated haemoglobin had significant association with occurrence of foot ulcers. MNSI scores had a high predictive value for development of foot ulcers amongst diabetics. Awareness regarding foot care was poor which underlines need to promote practice of foot care amongst diabetic population.

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Risk factors, ulcer grade and management outcome of diabetic foot ulcers in a Tropical Tertiary Care Hospital

Cited by 38 publications

References 14 publications

Untitled

Untitled

Assessment role of phagocytic neutrophil cells among different Wagner’s grades of diabetic foot ulcers infections

A study of risk factors and foot care behavior among diabetics

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