Diabetic foot : clinical presentation and management in al-Gamhuoria Teaching Hospital

Abstract EN

The aim of this study is to determine the mode of presentation, medical and surgical treatment, and prevention of diabetic foot.

This is a prospective descriptive study performed in the period from June 2004 – December 2005.

Eighty-three patients with diabetic foot lesion were presented to Al- Gamhorea Teaching Hospital.

Data of this patient were collected for sex, age, duration of diabetes, blood sugar control, mode of presentation, presence of peripheral neuropathy, peripheral vascular disease, concurrent medical illness (ischemic heart disease and chronic renal failure), and microbial flora, treatment by antibiotics, surgical treatment and duration of healing.

Majority of patients were male above 50 years 68.7 %, mean age 58.3 ± 12 and female 31.3%.

Most of them were type 2 on oral hypoglycemic drugs (89.16 %).

Blood sugar was uncontrolled in 77.1 % of them.

History of trauma preceding diabetic foot infection was present in 74.7 %.

Foot ulcer was the most common presentation in 47 % of patients.

There was a significant association between the peripheral neuropathy and the following risk factors : duration of diabetes more than ten years 100 % (p = 0.0000), poor glycemic control 95.3 % (p = 0.000) and trauma 83.9 % (p = 0.0000).

There was also a significant relationship between the major limb amputation and some predictive variables: previous foot ulcer 35.3 % (p = 0.0000), poor glycemic control 17.2 % (p = 0.04), peripheral neuropathy 17.7 % (p = 0.03), peripheral vascular disease 75 % (p = 0.000), and heart disease 33.3 % (p = 0.01).

Debridement done for 49.4 % and toe / s amputation for 30.2%, however 11 patients (13.3 %) had major amputation.

Staphylococcus aureus was the most common organism isolated in 34.9 %.

Duration of healing was 9-16 weeks for most of the patients 63.4 %.

Diabetic foot infection is a common health problem in Al-Gamhorea Teaching Hospital, particularly among men.

Poor glycemic control, as well as peripheral neuropathy and peripheral vascular disease are the most precipitating factor, which can be prevented.

Control of blood sugar, good debridement, and proper dressing can lead to early and complete healing in most of diabetic foot lesions.