The Presentation and Surgical Management of Diabetic Foot

Abstract

Objective: To highlight the presentation and management of diabetic foot disease.

Study Design: A retrospective study

Place and Duration of Study: This study was conducted at the Surgical Department of Khalifa Gul Nawaz Teaching Hospital (KGNTH) Bannu from June 2017 to July 2019 for a period of 02 years.

Materials and Methods: A total of 320 patients with diabetic foot ulcer with infection were included in this study.

Results: Out of these 320 patients, males were 208 (65%) and females 112 (40%). The average age was 53.5 years
(30-75 yrs ). Majority of the patients (90%) had type II diabetes mellitus (DM). 109 patients (34%) had suffered from DM for <10 years and 211 (66%) had been diagnosed for >10 years. In this study 272 patients (85%) were on oral hypoglycemic drug with diet control and the remaining 48 (15%) were on insulin. History of trauma preceding the infection was positive in 20% (64) patients. Previous history of ulcer and infection was positive in 45% (144) patients. Positive culture for polymicrobial infections was found in 90% (288) of patients. Staph aureus was the most common isolate along with strepto cocci, pseudomonas and anaerobes and fungi.

Conclusion: Diabetic foot infective disorder is a common cause of morbidity and mortality among patients with diabetes throughout the world and is a leading cause of non-traumatic lower limb amputation. A multidisciplinary team approach concentrating upon a tight glysaemic control, education on foot care, a suitable foot wear, control of infection and early surgical intervention is needed to decrease the morbidity and mortality of diabetic foot disease. Due to polymicrobial infection and antibiotic resistance, early surgical intervention must be provided.