Document Type : Original Article

Authors

1 CABS/ General surgeon/ College of medicine / Al-Muthanna University / Department of surgery / Al-Hussein Teaching hospital / Samawa / Al Muthanna

2 College of Veterinary Medicine / Al-Muthanna University

3 Department of Biochemistry and Molecular Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC, 20037, USA

Abstract

Background :  Globally, Diabetes Mellitus is a common health problem that occurs as a systemic disease affecting vascular, nervous, skeletal, immune, and integumentary systems.
The aim: This study aim and intends to evaluate and highlight on the management outcome of diabetic foot in AL-Hussein Teaching Hospital – Samawa / AL-Muthanna province and determine the risk factors adversely affecting the treatment prognosis.
Patient and Methods: Fifty patients diagnosed with Diabetic Foot Ulcer (DFU) ulcer were included in this study. The lesions were managed by removing dead tissue, triple antibiotic therapy, avoiding weight bearing, and proper diabetes control.
Results:According to gender, the percentage of DF was 34 (68%) and 16 (32%) for males and females, respectively. Moreover, the results showed that 22 (44%) and 28 (56%) display type I and type II DM, respectively. Also, 23 out of 50 (46%) patients were poorly controlled, and ten of these cases (43%) underwent amputation. According to Wagner Grading System; the patient's grade percentages were 2%, 30%, 20%, 22%, 14%, and 12 % for Grade 0, Grade I, Grade II, Grade III, Grade IV, and Grade V, respectively. All non-responded patients were those treated at home, had poor cooperation, neglect, and out-patient follow-up refusal and were subjected to amputation. The poorly controlled or uncontrolled DM, Ischemic heart disease (IHD), leukocytosis, anemia, impalpable dorsalis pedis pulse/s, smoking, neuropathy, patient's neglection and traditional home treatment were the common factors that revealed significant adverse effects on conservative treatment. While hyperglycemia, hypertension and site of management (surgical, orthopedic, out-patient or emergency departments) factors that revealed less or non-significant adverse effects on conservative treatment.
In conclusion, this study showed that type II DM was the most diabetic foot lesion. The study also approved that most patients were poorly controlled DM that ended with amputation, and most patients presented with Wagner's grade I.

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