ABSTRACT
Objective
To study results of diabetic foot infection treatment in a general surgery clinic and diabetes clinic.
Patients and Methods
Sixty patients with diabetic foot infection were enrolled in this prospective study during the September 2005 through August 2007. Statistical analysis was preformed. X2 test used to test for significance of differences.
Results
Ten patients out of 60 (17%) had below knee amputation after failure of local foot debridement.
Conclusion
Foot infection is a serious medical problem. Establishment of specialized diabetic foot care clinic is necessary for early intervention to prevent further deterioration that may lead to amputation.
Key words
Diabetic foot, amputation, diabetes mellitus.
INTRODUCTION
Diabetes mellitus is the most common metabolic disorder affecting humans. Of the estimated 21 million Americans with this disorder, approximately 90% have type 2 diabetes, which is caused by the dual defects of insulin resistance and beta-cell secretory dysfunction, both of which are aggravated by glucose toxicity and lipotoxicity .less than 40% of people with diabetes achieve recommended therapeutic goals. In the UK Prospective Diabetes Study (UKPDS), a 1% difference in A1C between "intensively" and "conventionally" treated subjects with type 2 diabetes (A1C 7.8% vs 8.8%) led to a 25% relative risk reduction for the onset or progression of microvascular complications (1). the typical patient with new-onset type 2 diabetes has had diabetes for at least 4-7 years before it is diagnosed (2). The 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 (World Health Organization, 1995) (3). Foot disease is the most common complication of diabetes mellitus leading to hospitalization (4). It is also the leading cause of lower extremity amputation in USA. It was estimated that diabetics are 12 times more likely to undergo amputation than non –diabetic (4) .As far as we know .clinics specializing in diabetic foot care are not yet available in Jordan. The establishment of such clinic and team management of foot infection has yielded an improved outcome for these patients.
PATIENTS AND METHODS
This is prospective study carried out at King Hussein Medical Center during the period between September 2005 through August 2007. The diagnosis of "diabetic foot" was made by endocrinologist and Surgeon. Sixty patients with diabetic foot infection were treated at medical and surgical wards during this period and all patients were seen by both physician and surgeon and both agreed management protocol .Information regarding diabetic history and its control, concomitant neuropathy or vascular insufficiency (absent pedal pulse) were also recorded.
According to Rancho Los Amigos Hospital classification, cases were classified into: a- cellulites with or without abscess formation, b-infected ulcer, c-inf
Key words: Diabetic foot, amputation, diabetes mellitus.
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