FREQUENCY, CLINICAL PRESENTATION AND MANAGEMENT OF DIABETIC FOOT: (THE MULTI-INSTITUTIONAL STUDY)

OBJECTIVE: To determine the frequency, clinical presentation and management of diabetic foot at tertiary care hospitals PATIENTS AND METHODS: This multi-institutional one year study descriptive case series was conducted on diabetic population had foot complications at Liaquat University Hospital & Govt Lyari general hospital Karachi. The inclusion criteria of the study were all the patients, ≥12 years of age, either gender with diabetes mellitus (type 1 or type 2) presented with foot ulcers, infection and gangrene of foot. The conservative management includes strict glycemic control, meticulous dressing and if needed approach for major surgical interventions. The data was recorded on pre-designed proforma while analyzed in SPSS 16. The frequency, percentages and mean ±SD calculated for study variables. RESULTS: During one year study period total seventy two patients of diabetic foot were enrolled and evaluated. The mean age ±SD for whole population was 52.85±8.93 while the mean ±SD for hemoglobin A1C, fasting and random blood sugar was 9.52±2.84, 169±7.74 and 276.92±8.96 respectively. Thirty subjects had a history of trauma before the onset of foot lesion and majority (75%) were belonged to rural populated areas and had history of diabetes for more than five years (77.7%). The common pathogen identified was staphylococcus aureus 38 (52.8%) and common procedures were slough excision and regular dressing 26 (36.1%) and split skin graft 14 (19.4%). CONCLUSION: Commonest presenting lesion was ulcer, cellulitis and Gangrene. Conservative treatment consists of control of diabetes along with antibiotics while the surgical interventions are other mode of treatment. Keywords: Diabetes mellitus, Foot ulcer and Diabetic foo