Diabetic foot ? A clinical study: Early surgical intervention is a key to early cure and rehabilitation in accordance with the international consensus on the Diabetic foot
Journal: International Archives of Integrated Medicine (IAIM) (Vol.3, No. 1)Publication Date: 2016-01-13
Authors : Umesh Kumar Chhabra; Sandeep Kumar Goyal; Satish Kumar Bansal; Gopal Singal;
Page : 110-115
Keywords : Diabetes mellitus; Glycosylated hemoglobin (HbA1c %); Trauma; Infection; Peripheral neuropathy; Gangrene; Early surgical intervention.;
Abstract
Background: Diabetes mellitus is as old as mankind and perhaps humans know it from early ages. It is one of the most deeply studied diseases and is still un-understandable ailment that humans deal with. As we are digging deeper into the molecular basis of the disease, mind boggling results are coming out. It is not a single disease but a constellation of diseases that it gives birth to i.e. the complications. The main aim of this study was to evaluate the ultimate outcome of patients who present with lower limb complications related to diabetes mellitus type ? 2 by early surgical intervention and to prevent infections to establish and become deep seated and involve deeper structures like muscles, bones or joints and to minimize the chances of amputation by early intervention. This study was carried out in Maharaja Agrasen Medical College, Agroha, Hisar, Haryana, India. Material and methods: The present prospective study was carried out on 150 patients who were suffering from foot ulcers in type ? 2 diabetes mellitus and were randomly selected. The selected patients were evaluated for the presence of complications like peripheral vascular disease, and neuropathy. The ulcers were swabbed, cultured and early surgical intervention was done after which wounds were dressed with either of the following: Saline gauze, Povidone-iodine, Hydrogel, Hydrocolloid base, Human Recombinant Platelet derived Growth Factor. Results: 150 patients (100%) required early debridement, 83 patients (55.33%) required Split Skin Grafting, 5 patients (3.33%) required flap, 38 patients (25.33%) did not require any further surgical treatment and their wounds healed with dressing alone, 24 patients (16%) required amputation. Conclusions: Patient characteristics, such as sex, age, poor glycemic control, presence of peripheral vascular disease, peripheral neuropathy and delayed surgical intervention have a poor outcome in form of complete wound healing in patients with Diabetic foot.
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Last modified: 2016-01-19 14:32:21