A CLINICAL STUDY OF DIABETIC FOOT ULCERS AND MANAGEMENT

Introduction: Diabetic foot may be defined as a group of syndromes in which neuropathy, ischemia and infection lead to tissue breakdown, resulting in morbidity and possible amputation. Foot problem remains very common in people with diabetes throughout the world, affecting up to 15% of diabetic patients during their life time. The aim of this study is to assess the various presentations of diabetic foot ulcers and surgical management.

Materials and Methods:This is a hospital based prospective observational study conducted in 50patients of diabetic foot ulcers admitted in the department of General Surgery at Zoram Medical College (ZMC), Falkawn, Mizoram during the period of November 2017 to December 2021. All patients with diabetes mellitus suffering from foot ulcers of all age groups, incidental diagnosis of diabetes with foot ulcers, patients with gangrenous foot complicated by diabetes are included.Patients with foot infections or gangrene foot without diabetes mellitus or incomplete treatment are excluded.

Results: The commonest presentation in this study is ulcer followed by gangrene and abscess. The most common site of lesion is toes (42%) followed by dorsum of foot (30%) and planter of foot (16%). 72% of patients (36) had neuropathy, 14% had vasculopathy and 10% had both. 30 (60%) patients are healed by debridement and dressing alone, 11 (22%) patients need amputation or disarticulation to heal. Skin grafting is done in 9 patients. No patient dies of the ulcer.

Conclusion: Diabetic foot ulcer is a complication of prolonged diabetes mellitus which increases with age and duration of the disease. The surgical management of diabetic foot ulcers should be based on the knowledge of pathophysiology of diabetes and practice of new treatment modalities.