Characteristics of foot ulcers in diabetic patients

INTRODUCTION: Diabetic foot syndrome is often presented as a skin lesion in diabetics. The aim of our study was to analyse foot ulcerations in diabetics, together with ethiopatogenesis, location and grade of impairment. METHODS: We analysed foot ulcerations in 124 diabetics who attended outpatient foot clinic, or were hospitalized in the period from 1996 to 2006. Basic neuropathy screening examination was made with cotton wisp, pin-prick, tuning fork, and monofilament. Beside the evaluation of the presence of pedal pulses, the ankle-brachial pressure index was measured. If the infection of foot ulceration was present, bacteriology examinations was performed. Wagner and University of Texas classifications of foot ulcerations were applied, moreover, location of ulcerations was analysed. RESULTS: Neuropathic ulcer was diagnosed in 46 patients of the total number of 124 (37%), neuroischemic in 76 patients (61%) and pure ischemic ulcer only in 2 patients (2%). Neuropathy was present in 122 (98%) patients with diabetic foot, limb ischemia in 78 patients (63%). Fifty four per cent of foot ulcers were located on toes and 43% ulcers on plantar surface. Foot ulcer infection was detected in 72 patients (58%). We found 48 superficial ulcers (38.7%) and 76 deep ulcers (61.3%). In diabetics without foot ischemia and infection 39% deep ulcers were present whereas in the group with ischemia and infection the proportion amounted to 80% (p < 0.05). CONCLUSION: Diabetic foot syndrom was present more often in type-2 diabetics with longer disease duration, in those on insulin treatment, in men of older age, further in the diabetics with pure glycemic control and/or with chronic microvascular diabetic complications.