Formulating Treatment Protocol in Diabetic Foot by Assessment of Neurological, Vascular, Dermatological and Skeletal Status

Background: Diabetic foot is one of the most significant and devastating complications of diabetes and is defined as a foot affected by ulceration that is associated with neuropathy and / or peripheral arterial disease of the lower limb in a patient with diabetes, especially among the older population. Aims and objective: Formulating treatment protocol (medical, conservative and surgical) in diabetic foot by assessment of neurological, vascular, dermatological and skeletal status. Material and method: A Prospective study was carried out in patient presented with diabetic foot and were treated by classifying the patients into neurological, vascular and neurovascular lesion related groups. Patients managed by medical treatment, conservative (I&D and fasciotomy, slough excision and debridement, regular dressing) or surgical (split thickness skin graft or flap rotation, angioplasty/bypass surgery, major/minor amputation) with strict glycemic control, health education, and use of offloading or protective footwear and followup for outcome.Results: In study, out of 50 patient, 41 patient (82 %) was improved as healing of wound was good under 20 weeks of duration of followup and 9 patients (18 %) was not healed. Out of 13 cases of neurological patient, 12 cases (92.30 % of total neurological) had good out come, out of 9 cases of vascular lesion, 8 cases ( 88.88 % of total vascular) had good out come and out of 28 cases of neurovascular cases, 21 cases (75 % of total neurovascular) had also good out come. In study healing rate was good because of better protocol for management of diabetic foot by clinical assessment and proper treatment as formulated. Conclusion: Diabetic patients have always suffered from complications affecting the lower limbs. Foot infection and the subsequent amputation of a lower extremity are the most common cause of hospitalization among diabetic patients.Education regarding foot care and early clinical screening play a vital role in the prevention.