Risk factors in the development and Progression of diabetic ulcers and their Outcome in a tertiary care hospital
Keywords:Diabetic foot ulcers, Glycaemic control, Peripheral neuropathy, Peripheral Vascular Disease.
Introduction: There is an increase in the number of diabetic patients now a days and the lifetime risk of a patient with diabetes developing a foot ulcer is very high. Early diagnosis and presentation to hospital for prompt treatment of diabetic foot ulcer is capable of reducing the significant morbidity and mortality. Early detection of peripheral neuropathy, patient's education regarding foot care and customized footwear is crucial in reducing risk of any injury that can lead to ulcer formation.Material and Methods:A hospital based prospective observational study was conducted on diabetic patients in kamineni Hospitals, L B Nagar, Hyderabad during a period of 2 year from July 2018 to June 2020. The influence of various risk factors in development and progression of diabetic ulcer and their influence on outcome was studied. Results: 150 patients with diabetes ranging in age from 21 years to 95 years were studied. Most of the patients in our study come from low and medium socioeconomic status. Mean duration of diabetes is 4.9 years. History of trauma was absent in 101 patients (67.3%). Majority of the patients in the study population were having poor glycaemic control. In thisstudy 41 patients (27.3%) were diagnosed to have PVD and neuropathy was seen in 54 patients (36%) whereas 96 patients (64%) had no signs of neuropathy. Patients were followed for a period of 3 months and found that 98 patients (65.3%) diabetic ulcers healed, 34 patient’s ulcers were chronic non healing ,10 patients underwent disarticulation of single or multiple toes, 6 patients underwent major surgery-below knee amputation and 2 patients needs split skin grafting.Conclusion:Diabetic foot ulcer outcomes can be predicted by several factors, some of whichare modifiable. Modification for the modifiable factors, such as better glycaemic control, treatment of peripheral neuropathy, and early management of ulcers, may improve the outcome and facilitate healing.
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Copyright (c) 2021 Punyapu Sridhar, A.Sashidhar Rao, Kar thik, G. Satyanarayana, Samiud din
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