A Clinical Study in Diagnosis and Management of Diabetic Foot
نویسنده
چکیده
India has the dubious distinction of becoming the diabetic capital of the world within the next few years; with its attendant complications, it is going to burden the resources of the country. The countries with the greatest number of individuals with diabetes in 2013 are China and India. A majority of diabetic patients develop foot ulcers in one point of time or other during the course of their illness. A significant number of such patients will require long-term hospital treatment and amputations. The etiopathogenesis of diabetic foot lesions are multifactorial. The classical triad of neuropathy, ischaemia and infection characterizes the diabetic foot. The objective of study is to analyse the various modes of clinical presentation. To determine commonest microorganisms infecting the diabetics and to evaluate the usefulness of management protocols with special emphasis on strict glycaemic control. This is a prospective study of 50 diabetic patients with foot problems who attended department of General Surgery of Mahadevappa Rampure Medical College, Kalaburagi from December 2015 to May 2016. These patients underwent thorough evaluation and treatment on IPD basis. Documentations of patients which includes identification, history, clinical findings, investigative tests, treatment given were all recorded in a proforma. In our series of 50 patients, the highest incidence was in the age group of 51-60 years with mean age of 61.2 years, 76% were males; most common presentation was cellulitis(50%). 72% of them had history of trauma, most have duration of diabetes 1-5 years. Majority had both neuropathy and vascular disease, only 20% had osteomyelitis; majority were farmers(54%), and most common organism was Staph aureus. Only 16% had HbA1 c level < 7mg% and they have shorter hospital stay. Most common presentation was cellulitis. Common etiology was trauma. Most common organism infecting was Staph aureus. Most common modality of treatment was debridement and patients whose HbAlc was <7mg% had shorter hospital stay indicating strict glycemic control was necessary for better wound healing.
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