Skip to main content
Log in

Prevalence of Ischemia in Diabetic Foot Infection

  • Original Scientific Reports
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Foot infection is a common problem affecting diabetics. In addition to neuropathy, ischemia is a major factor contributing to the progress and morbidity of the disease. The aim of this study was to determine the prevalence of lower limb ischemia in patients with diabetic foot infection by prospectively measuring the ankle-brachial pressure index (ABI). Over a 21-month period 60 patients were treated in the general surgical ward of Princess Basma Teaching Hospital. Ischemia was present in 35 of the 60 patients (58.4%). Among them 27 had moderate ischemia (ABI 0.5–0.9) and were treated successfully before further vascular workup. The other 8 patients had severe ischemia (ABI < 0.5) and required below-knee amputation because their feet were severely infected and not salvageable. This study confirmed the recommendation for early detection of lower limb ischemia in diabetics, especially those with foot infection, as it should improve the outcome of treatment. In addition to patient education and periodic foot examinations, estimating the ABI is an easy. reliable way to determine foot blood flow and to detect patients who require further vascular workup and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. RMcI Briddges SuffixJr EA Deitch (1994) ArticleTitleDiabetic foot infections: pathophysiology and treatment Surg. Clin. North Am. 74 537–555 Occurrence Handle8197529

    PubMed  Google Scholar 

  2. M Kalani K Brismar B Farell et al. (1997) ArticleTitleTranscutaneous oxygen tension and toe blood pressure as predictors for outcome of diabetic foot ulcers Diabetes Care 22 147–151

    Google Scholar 

  3. M Vaysairat C Devehat ParticleLe (2001) ArticleTitleDiabetic angiopathy: the role of microvascular exploration in routine practice; consequences of a new algorithm for care of the diabetic foot J. Mal. Vasc. 26 126–129 Occurrence Handle11319419

    PubMed  Google Scholar 

  4. L Stephen SuffixIII I Golde RB Holtzman (1999) ArticleTitleThe effects of peripheral vascular disease with osteomyelitis in diabetic foot Am. J. Surg. 177 282–286 Occurrence Handle10.1016/S0002-9610(99)00050-1 Occurrence Handle10326843

    Article  PubMed  Google Scholar 

  5. VJ Mandracchia RM Yoho et al. (1998) ArticleTitleThe diabetic foot: evaluation and patient education Hosp. Med. 34 41–44

    Google Scholar 

  6. PE Holstein S Sorensen (1999) ArticleTitleLimb salvage experience in a multidisciplinary diabetic foot unit Diabetes Care 22 97–103

    Google Scholar 

  7. JE Shaw AJM Boulton (2001) The diabetic foot JD Beard PA Gaines (Eds) Vascular and Endovascular Surgery EditionNumber2nd edition Saunders London 105–125

    Google Scholar 

  8. BA Lipsky RE Pecoraro LJ Wheat (1990) ArticleTitleThe diabetic foot: soft tissue and bone infection Infect. Dis. Orthop. Am. 4 409–432 Occurrence Handle1:STN:280:By6D3M%2FmtFc%3D

    CAS  Google Scholar 

  9. I Penn (1985) The impact of diabetes mellitus on extremity ischemia RF Kempezinski (Eds) The Ischemic Leg Year Book Chicago 56–69

    Google Scholar 

  10. GE Reiber L Vileikyte EJ Boyko et al. (1999) ArticleTitleCausal pathways for incident lower-extremity ulcers in patients with diabetes from two settings Diabetes Care 22 157–162 Occurrence Handle1:STN:280:DyaK1M3ms1Clsw%3D%3D Occurrence Handle10333919

    CAS  PubMed  Google Scholar 

  11. J Apelgvist J Larsson (2000) ArticleTitleWhat is the most effective way to reduce incidence of amputation in the diabetic foot? Diabetes Metab. Res. Rev. 16 S75–S83

    Google Scholar 

  12. C Steffen S O’Rourke (1998) ArticleTitleSurgical management of diabetic foot complications: the far north Queensland profile Aust. N. Z. J. Surg. 68 258–260 Occurrence Handle1:STN:280:DyaK1c3jt1SnsQ%3D%3D Occurrence Handle9572332

    CAS  PubMed  Google Scholar 

  13. P Laing (1998) ArticleTitleThe development and complications of diabetic foot ulcers Am. J. Surg. 176 S11–S19 Occurrence Handle10.1016/S0002-9610(98)00182-2

    Article  Google Scholar 

  14. National Diabetes Advisory Board. (1983) The prevention and treatment of five complications of diabetes: a guide for primary care practitioners. HHS Publ. No. 83-8392. Atlanta, Centers for Disease Control

    Google Scholar 

  15. TA King RG DePalma RS Rhodes (1984) ArticleTitleDiabetes mellitus and atherosclerotic involvement of the profunda femoris artery Surg. Gynecol. Obstet. 159 553–556 Occurrence Handle1:STN:280:BiqD28nivVA%3D Occurrence Handle6505941

    CAS  PubMed  Google Scholar 

  16. M Vayssairat C Devehat ParticleLe (2001) ArticleTitleCritical analysis of vascular explorations in diabetic complications J. Mal. Vasc. 26 122–125 Occurrence Handle1:STN:280:DC%2BD3M3ovVansQ%3D%3D Occurrence Handle11319418

    CAS  PubMed  Google Scholar 

  17. MJ Jacobs DT Ubbink PJ Kitslaar et al. (1992) ArticleTitleAssessment of microcirculation provides additional information in critical limb ischaemia Eur. J. Vasc. Surg. 6 135–141 Occurrence Handle1:STN:280:By2B2c7ks1Q%3D Occurrence Handle1572453

    CAS  PubMed  Google Scholar 

  18. AL Dellon (1992) ArticleTitleTreatment of symptomatic diabetic neuropathy by surgical decompression of multiple peripheral nerves Plast. Reconstr. Surg. 89 689–697 Occurrence Handle1:STN:280:By2C1cjnsVE%3D Occurrence Handle1546082

    CAS  PubMed  Google Scholar 

  19. CK Bowering (2001) ArticleTitleDiabetic foot ulcers: pathophysiology, assessment, and therapy Can. Fam. Physician 47 1007–1016 Occurrence Handle1:STN:280:DC%2BD3MzjtV2ksg%3D%3D Occurrence Handle11398715

    CAS  PubMed  Google Scholar 

  20. SB Alberksten BM Henriksen PE Holstein (1997) ArticleTitleMinor amputations on the feet after revascularization for gangrene: a consecutive series of 95 limbs Acta Orthop. Scand. 68 291–293 Occurrence Handle9246996

    PubMed  Google Scholar 

  21. ME Edmonds MP Blundell ME Morris et al. (1986) ArticleTitleImproved survival of the diabetic foot: the role of specialized foot clinic Q. J. Med. 60 763–771 Occurrence Handle1:STN:280:BiiD2c7ovFc%3D Occurrence Handle3774959

    CAS  PubMed  Google Scholar 

  22. GR Spollet (1998) ArticleTitlePreventing amputations in the diabetic population Nurs. Clin. North Am. 33 629–641

    Google Scholar 

  23. JM Malon M Synder G Anderson et al. (1989) ArticleTitlePrevention of amputation by diabetic education Am. J. Surg. 158 520–524 Occurrence Handle2589581

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Muhammad R. Khammash M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Khammash, M., Obeidat, K. Prevalence of Ischemia in Diabetic Foot Infection. World J. Surg. 27, 797–799 (2003). https://doi.org/10.1007/s00268-003-6889-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-003-6889-8

Keywords

Navigation