Abstract
Aim-Background
With the availability of insulin therapy, diabetes is no longer a fatal disease and with the increased life expectancy in diabetic patients, long term complications have become more common. Diabetic foot is the most common complication of diabetes mellitus presenting for surgical management. The aim of this study is to evaluate and suggest how to manage the different lesions of diabetic foot, according to Wagner’s classificationand compare outcomes ofthe surgical management.
Methods
This prospective observational study was conducted at a tertiary care teaching hospital in West Bengal, India over an eighteen-month period. 50 consecutive patients with diabetic foot disease were included in the study. Data collected included age, sex, socioeconomic status, duration and type of diabetes, Wagner’s Classification, examination findings, presence of neuropathy, presence of ischaemia, investigations including blood sugar profile, renal functions, lipid profile, glycosylated haemoglobin, swabs from wound / ulcer, Arterial Doppler and X-Ray of the affected foot. The patients were evaluated and managed by classifying their disease according to Wagner’s classification for diabetic foot disease.
Results
Age ranged from 33 years to 75 years, with the maximum number of cases being in the age group of 51-60 years. There were fourty two (84%) males and eight (16%) females. Neuropathy was present in 54% and ischaemia in 34% of the patients. The most common presentation was an ulcer followed by an abscess. Maximum patients presented with Wagner’s Grade 2 lesions. In this study 14% patients responded to conservative treatment with antibiotics, 42% patients underwent debridement, 12% required disarticulation and 4% required major amputations.
Conclusion
Early hospitalization, effective glycaemic control, aggressive debridements and patient education in foot care can minimize foot diseases [1]. Grading the lesion according to Wagner’s classification helps to plan the management.
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Ghosh, P.S., Mukhopadhyay, M., Das Chattopadhyay, S. et al. Management of diabetic foot disease in Eastern India. Hellenic J Surg 88, 311–313 (2016). https://doi.org/10.1007/s13126-016-0339-1
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DOI: https://doi.org/10.1007/s13126-016-0339-1