Background: Diabetic foot ulcer is most commonly encountered in diabetic patients for long duration. With neuropathy.
Aim: To study the bacteriology, pathophysiology of diabetic foot, various limb salvage procedures and outcome, different treatment modalities and newer techniques wherever applicable to prevent complications and to minimise the progression of occurred complication.
Materials and Methods: It is a prospective study of patients who presented with wound in the foot in the duration of August 2018 – December 2019. The primary outcome of the study was evaluated on the basis of clinical examination, investigations, duration of hospital stay, conservative management or need for major surgical interventions, and postoperative complications. Results: 78 male and 22 female patients were selected for the study. Highest number of cases was found in 51-60 years of age (34%) with youngest being 34 and oldest being 78. Majority of the patients in the study revealed history of trauma preceding the foot complications and the chances of injury is increased in these patients because of increased incidence of ischemia, neuropathy and infection. The study also indicates the increased foot complications in persons whose occupation precedes to trauma. 30 patients in this study had neuropathy, 16 patients had ischemia and all cases had culture positive. 32 cases were managed by daily dressing and wound debridement, and slough excision. 18 patients were treated with Split skin graft, 6 patients with I & D for abscess, 6 patients fasciotomy and followed by dressing, 20 cases with disarticulation, BKA was done in 8 cases and AKA in 10 cases.
Conclusion: Males are almost four times more affected than females, duration of diabetes varied among the patients from 1 year to 22 years and many patients were diagnosed post admission, trivial trauma of some kind was the initiating factor in nearly half of the cases, commonest presenting lesion was Ulcer 52%, conservative treatment consisting of control of diabetes was effective, neuropathy treated with methyl Cobalamin. Neuropathic foot was offloaded. Wound debridement, slough excision followed by dressing resulted in healing in some cases. Diabetic foot wear were advised for the patients. Split skin grafts, Disarticulation needed for some patients. In complicated cases patients with other comorbid conditions like atherosclerosis, hyperlipidemia it may even lead to below knee amputation and above knee amputations were the other modes treatment.