Clinico-social Profile and Surgical Management of Cases of Diabetic Foot: a Prospective Study

Diabetes continues to be the most common chronic disease in the developed countries, with increasing trend in India. Foot ulcers are among the leading causes of morbidity in diabetics and as such diabetic foot infection is a common cause for the hospital admissions of the diabetic patients in India. This could be attributed to several socio-cultural practices, low education and poor socio-economic conditions. Objective: To study the clinico-social profile and surgical management of patients presenting with diabetic foot. Materials and Method: This is a descriptive cross-sectional study which was carried out on 150 patients with diabetes mellitus with associated surgical complications who presented to Surgery Department of SSIMS and Research Centre, Davanagere for a period of one year from February 2012 to March 2013. Data was collected by detailed history followed by clinical examination diagnostic procedures and surgical management. Results: A total of 150 patients were selected for the study. There is a higher incidence in male patients (70%) and majority of patients (42%) belonged to lower socioeconomic status Average age of presentation was 56 years. Staph.aureus was the most common organism isolated from diabetic foot infections and ulcer (60%) was the commonest presenting feature followed by cellulitis(15%).Severity of lesion correlated with severity and duration of diabetes. The average duration of diabetes is 9.6 years. 24 % presented with osteomyletic changes on X-Rays of feet. The average duration of hospital stay was 15 days. Conclusion: Diabetic foot infections are the most common complication of diabetes mellitus resulting in disabilities, which get reported to surgeons and require multidisciplinary approach for its management. Prevention in the form of good diabetes control is the best modality. While much emphasis should be given on patient education regarding diabetes control, foot care, early reporting of infections and continuing treatment even after leaving the hospital. A team approach with aggressive and appropriate medical and surgical treatment according to grade of disease will go a long way in improving the outcome and reducing the morbidity and mortality due to diabetes.