scholarly journals Efficacy of diabetic ulcer severity score in patients with diabetic foot ulcer in predicting prognosis

2021 ◽  
Vol 8 (10) ◽  
pp. 2961
Author(s):  
Robinson George ◽  
Joe Mathew ◽  
Vishnu M. L. ◽  
Jacob P. Thomas
Keyword(s):  
Diabetic Foot ◽  
Severity Score ◽  
Scoring System ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Major Amputation ◽  
Classification Systems ◽  
Clinical Parameters ◽  
Diabetic Ulcer

Background: Diabetic foot ulcer (DFU) is a full-thickness wound, skin necrosis or gangrene below the ankle induced by peripheral neuropathy or peripheral arterial disease in patients with diabetes. There are well-accepted classification systems for DFUs, namely Wagner’s scoring system, university of Texas scoring system etc. However, only few are scientifically validated. Diabetic ulcer severity score (DUSS) introduced by Beckert et al consists of easily accessible clinical parameters which categorizes wounds into specific subgroups for comparison of outcomes.Methods: A prospective study was conducted on 250 diabetic ulcer patients, attending the out-patient department (OPD) of surgery, Pushpagiri institute of medical sciences, Tiruvalla.Results: Most common age group affected with diabetic foot was between 51-60 years (mean 58.9±10.2 years). Males accounted for 54% of patients. Most common ulcers were of score of 2 followed by score 3. Overall, 105 (42%) of 250 people had amputations in our study with majority undergoing minor amputation (30%) than the major amputation (12%). None of the patients with scores 0, 1 and 2 had major amputation. Probability of healing among the various scores were-100% for score 0, 97.9% for score 1, 83.4% for score 2, 17.7% for score 3 and 4.8% for score 4. Lower score is strongly associated with primary healing and higher score with amputations.Conclusions: DUSS system is an easy wound based diagnostic tool for anticipating probability of healing or amputation and need for surgery by assessing the four clinical parameters and combining them which is safe and easily reproducible.

scholarly journals “ ASSESSMENT OF SEVERITY OF DIABETIC FOOT ULCERS USING DIABETIC ULCER SEVERITY SCORE.”

2020 ◽  
pp. 19-21
Author(s):  
Aarushi Mishra ◽  
Anilkumar P. Bellad ◽  
M.I. Uppin
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Severity Score ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
The Past

INTRODUCTION : Diabetes mellitus is a common metabolic disorder, prevalence steadily increasing over the past few decades. The complications associated with it , hence , has also increased. Diabetic foot ulcer is one of the most serious complications , utilizing resources, significantly contributing to the morbidity of the patient. There is hence, a need to correctly identify the severity of the diabetic foot ulcer so as to plan the appropriate management and to help in counselling of such patients. AIM : To assess severity in diabetic foot ulcer using diabetic ulcer severity score. MATERIAL AND METHODOLOGY : This is a hospital based longitudinal study , conducted on 93 study subjects admitted with diabetic foot ulcers. Diabetic ulcer severity score was calculated for each patient . The score was calculated by adding scores of the respective parameters constituting site of ulcer, number of ulcers, presence/absence of pedal pulsations, presence/ absence of bone involvement. Each patient was followed up for a period of 6 months , or earlier in case of patient undergoing minor/major amputation. After the study was conducted , analysis was done by calculating various percentages of healing /amputation with respect to the score. RESULTS : Out of the total 93 study subjects , 74.2% were males. The mean age was calculated to be 59.6 years with maximum number of subjects being in 55-60 years of age group range. Majority of them had diabetic ulcer severity score of 2 (42%). Out of the total study subjects , 58% had a complete healing , 28% underwent minor amputation whereas 14% underwent major amputation. 100% of the study participants with score 0 had healing of ulcer which decreased to 85% for score 1 , 53.8% for score 2 , 6.25% for score 3 and 0% for score 4. This was suggestive of poorer chances of healing as the diabetic ulcer severity score increases. CONCLUSION : With the increasing incidence of patients diagnosed with diabetes mellitus , the rate of complications of diabetes has also increased over the past few decades including the risk and occurence of diabetic foot ulcers There is an increasing need for diabetic foot ulcer prognostication systems and universal use of the same. Thus ,we recommend the use of diabetic ulcer severity score as a prognostic tool to assess the severity of the diabetic foot which will further enhance communication and counselling of the patient and will help in providing the appropriate treatment to such patients.

Study of diabetic foot ulcer outcomes using diabetic ulcer severity score

2019 ◽  
Vol 11 (1) ◽  
pp. 57-60
Author(s):  
Sabu Ningappa Satihal ◽  
◽  
Vijaykumar Patil ◽  
Keyword(s):  
Diabetic Foot ◽  
Severity Score ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Diabetic Ulcer

scholarly journals Characteristics and Outcome for Persons with Diabetic Foot Ulcer and No-Option Critical Limb Ischemia

2020 ◽  
Vol 9 (11) ◽  
pp. 3745
Author(s):  
Marco Meloni ◽  
Valentina Izzo ◽  
Valerio Da Ros ◽  
Daniele Morosetti ◽  
Matteo Stefanini ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Critical Limb Ischemia ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Major Amputation ◽  
Peripheral Arterial ◽  
Stage Renal Disease

The study aimed to evaluate clinical and vascular characteristics, as well as outcomes, for diabetic persons with foot ulceration and no-option critical limb ischemia (CLI). The study group included a sample of patients admitted to our diabetic foot unit because of a new diabetic foot ulcer and CLI. All subjects were managed using a limb salvage protocol which includes lower-limb revascularization. According to whether or not the revascularization procedure was a success, patients were respectively divided into two groups: successfully treated CLI patients (ST-CLI) and no-option CLI patients (NO-CLI). Failed revascularization was considered in the case of technical recanalization failure of occluded vessels (inability to overcome the obstruction) and/or absence of arterial flow to the foot. Limb salvage, major amputation, and death after 1 year of follow-up were evaluated and compared between the two groups. Overall, 239 patients were included, 74.9% belonging to ST-CLI and 25.1% to NO-CLI. NO-CLI patients reported more cases of ischemic heart disease (80 vs. 62.1, p = 0.008), heart failure (63.3 vs. 32.4%, p < 0.0001), and end-stage renal disease (ESRD) (60 vs. 25.7%) than ST-CLI patients. In addition, more vessels were affected in the NO-CLI group (5.2 ± 1.6 vs. 4 ± 1.5, p < 0.0001), and there was more involvement of tibio-peroneal trunk (50 vs. 30.2%, p = 0.006), anterior tibial (93.3 vs. 82.7, p = 0.03), posterior tibial (93.3 vs. 73.7%, p = 0.0005), peroneal (70 vs. 48%, p = 0.002), and below-the-ankle arteries (73.3 vs. 39.1%, p < 0.0001) than ST-CLI. The 1 year outcomes for the whole population were 69.9% limb salvage, 10.9% major amputation, and 19.2% death. The outcomes for NO-CLI and ST-CLI were, respectively, as follows: limb salvage (13.8 vs. 73.4%, p < 0.0001), amputation (30 vs. 4.5%, p = 0.0001), and mortality (50 vs. 8.9%, p < 0.0001). NO-CLI patients showed a more severe pattern of peripheral arterial disease (PAD) with distal arterial lesions and worse outcomes than ST-CLI.

scholarly journals Role of ulcer grading classification in predicting level of amputation in diabetic foot ulcer.

2020 ◽  
Vol 27 (09) ◽  
pp. 1931-1935
Author(s):  
Khalil ur Rehman ◽  
Muhammad Naeem Ashraf ◽  
Naveed Arshad ◽  
Saima Mir ◽  
Nadeem Pasha
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Major Amputation ◽  
Cross Sectional ◽  
Diabetic Ulcer ◽  
Minor Amputation ◽  
Increased Risk ◽  
Study Results

Objectives: The study was designed to analyze and predict the diabetic foot ulcer outcome in terms of either healing or progression to amputation in patients presenting with diabetic foot. Study Design: Cross Sectional study. Setting: POF Hospital Wah Cantt. Period: January 2017 to December 2017. Material & Methods: Demographics of patients along with duration of diabetic foot ulcer and its grade according to Wagner classification were recorded. Nonprobability consecutive sampling was done for the data collection. Management of ulcer was carried out with debridement, daily dressings and appropriate antibiotic. Patients were followed over period until ulcer healed completely or amputation performed. The outcome of diabetic foot ulcer was noted to complete the study. Results: One hundred patients with mean age were 54.24±3.65 years. Mean duration of diabetic ulcer was 17.61±4.6 days. All patients with grade I ulcer recovered completely without the need of amputation. Out of 25 patients with grade II ulcers 13 (52%) patients recovered without amputation while 12 (48%) patients had minor amputation. Similarly 16 patients presenting with grade III ulcers 12 (75%) had minor amputation while 4 (25%) underwent major amputation. Out of 18 patients with grade IV ulcers, 6 (33%) had minor amputation while 12 (67%) had major amputation. All 13 patients with grade V ulcer underwent major amputation. Relation of grades of ulcer with respect to level of amputation inside the grading classification of ulcer showed significant (p=0.000). Conclusion: Healing of the diabetic foot ulcer with preservation of limb function must be a goal of treating diabetic foot. Wagner classification of diabetic foot ulcer high grade is associated with increased risk along with high level of foot amputation.

scholarly journals Epidemiology and Burden of Diabetic Foot Ulcer and Peripheral Arterial Disease in Korea

2019 ◽  
Vol 8 (5) ◽  
pp. 748 ◽  
Author(s):  
Dong-il Chun ◽  
Sangyoung Kim ◽  
Jahyung Kim ◽  
Hyeon-Jong Yang ◽  
Jae Heon Kim ◽  
...  
Keyword(s):  
Health Care ◽  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Total Population ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Major Amputation ◽  
Using Data ◽  
Peripheral Arterial

Information about the epidemiology of diabetic foot ulcer (DFU) with peripheral arterial disease (PAD) is likely to be crucial for predicting future disease progression and establishing a health care budget. We investigated the incidence and prevalence of DFU and PAD in Korea. In addition, we examined costs of treatments for DFU and PAD. This study was conducted using data from Health Insurance Review and Assessment Service from 1 January 2011 to 31 December 2016. The incidence of DFU with PAD was 0.58% in 2012 and 0.49% in 2016. The prevalence of DFU with PAD was 1.7% in 2011 to 1.8% in 2016. The annual amputation rate of DFU with PAD was 0.95% in 2012 and 1.10% in 2016. Major amputation was decreased, while minor amputation was increased. The direct cost of each group was increased, especially the limb saving group. which was increased from 296 million dollars in 2011 to 441 million dollars in 2016. The overall incidence of DFU with PAD was about 0.5% of total population in Korea, from 2012 to 2016. Furthermore, costs for treatments of diabetic foot ulcer are increasing, especially those for the limb saving group.

scholarly journals PEDIS Classification in Diabetic Foot Ulcers Patients

2020 ◽  
Vol 1 (2) ◽  
pp. 50-54
Author(s):  
Radi Noorsyawal ◽  
Fahmi Jaka Yusuf ◽  
Kemas Dahlan ◽  
Ratna Maila Dewi
Keyword(s):  
Peripheral Arterial Disease ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
The United States ◽  
Classification Systems ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Peripheral Arterial

Introduction: Diabetic foot ulcer are one of several serious complications of diabetes progression. Up to 15% of patients with diabetes have diabetic foot ulcer and these ulcers lead to more than 80,000 amputations per year in the United States. Many DFU classification systems have been proposed to predict clinical outcome; however, almost of these systems have limitations. To categorize and define DFU objectively, the International Working Group of the Diabetic Foot (IWGDF) developed the PEDIS classification system. These collective findings and because of there is no findings of characteristic of DFU based on PEDIS classification in Mohammad Hoesin Hospital indicate that this research is needed to do. Method: This is a prospective study at Mohammad Hoesin hospital, Palembang. The aim is to describe the characteristic of diabetic foot ulcers based on PEDIS classification. There were 41 cases evaluated under this study. Results: Peripheral arterial disease is the most problem in perfusion. 1-3 cm2 is the most happen in extent. Wound depth on fascia or muscle or tendon is the most happen. Abscess or fascitis is the most problem in infection. Loss of sensation is the most happen. PEDIS score ≥ 7 is the most happen. Conclusion: Early prevention and treatment from vascular and endovascular surgery can be considered as the most important for the management of diabetic foot ulcers patient. Keywords: Diabetic Foot Ulcer, PEDIS classification, Peripheral Arterial Disease

scholarly journals Clinical utility of diabetic ulcer severity score in surgical practice

2019 ◽  
Vol 6 (7) ◽  
pp. 2469
Author(s):  
Jose V. Francisco Menezes ◽  
Sreenidhi G. M. ◽  
Satya Vani K.
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Clinical Tool ◽  
Aggressive Approach ◽  
Diabetic Ulcer ◽  
Surgical Practice

Background: In surgical practice we come across many diabetic foot ulcer patients who often present late, leading to limb loss and even death. In the search for an effective screening tool to assess the severity of the disease and predict the outcome we have adopted the DUSS.Methods: Prospective study from October 2016 to April 2018 including 200 patients with diabetic foot ulcers conducted at Surgery Department in KIMS, Bangalore. DUSS was applied at the time of admission. DUSS comprises 4 clinical parameters: 1) pedal pulses, 2) probing to bone, 3) ulcer site and 4) ulcer number. These wounds were graded into score 0, 1, 2, 3, 4. Standard management was given to all patients according to a protocol. The outcome of treatment was recorded as healed ulcer, minor amputations, (toe or forefoot) or major amputations (below or above knee). Co-relation between the DUSS scores and final outcome was done.Results: Healing rates were higher in those with lower DUSS scores (88.9% in score 0 compared to 0% in Score 4). Minor amputation rates for scores 0, 1, 2,3 were 11.1%, 30.5%,28.3% and 44.1% respectively. Major Amputation rates were higher in patients with high DUSS scores i.e. 3 (41.8%) and 4 (100%).Conclusions: DUSS is an effective clinical tool to assess the severity of diabetic foot ulcers. DUSS scores help in predicting the outcome of treatment hence it can be used to counsel the patient regarding the disease and its prognosis. Patients with higher DUSS scores should require a more aggressive approach to minimise morbidity and mortality.

Treatment Strategies Against Diabetic Foot Ulcer: Success so far and Road Ahead

2020 ◽  
Vol 16 ◽  
Author(s):  
Ankit Awasthi ◽  
Sachin Kumar Singh ◽  
Bimlesh Kumar ◽  
Monica Gulati ◽  
Rajesh Kumar ◽  
...  
Keyword(s):  
Lower Limb ◽  
Diabetic Foot ◽  
Treatment Strategies ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Current Status ◽  
Limb Amputation ◽  
Bibliographic Databases ◽  
Inflammatory Phase

Background: Diabetic foot ulcer (DFU) is one of the leading complications of type-2 diabetes mellitus. It isassociated with neuropathy and peripheral arterial disease of the lower limb in patients with diabetes. Basically, there are four stages of wound healing namely hemostasis phase, inflammatory phase, proliferative phase and maturation phase. In case of DFU, all these stages are disturbed which lead to delay in healing and consequently to lower limb amputation. Traditionally the dosage forms like tablets, creams, ointments, gels and capsules have been used for the treatment of diabetic foot ulcer from many years. Introduction: In this review the global prevalence as well as etiopathogenesis related to diabetic foot ulcer has been discussed. Potential role of various synthetic and herbal drugs as well as their conventional dosage form for the effective management of diabetes foot ulcer has been highlighted. Methods: Structured search of bibliographic databases for previously published peer-reviewed research papers was explored and data was culminated in terms of various approaches that are used for the treatment of diabetic foot ulcer. Results: About 142 papers including both, research and review articles, were included in this review in order to produce a comprehensive as well as readily understandable article. A series of herbal and synthetic drugs have been discussed along with their current status of treatment in terms of dose and mechanism of action. Conclusion: DFU has become one of the most common complications in patients having more than ten years of diabetes. Hence, understanding the root cause and its successful treatment is a big challenge because it depends upon multiple factors such as judicious selection of drug as well as proper control of blood sugar level. Most of the drugs that have been used so far either belong to the category of antibiotics, antihyperglycaemics or, they have been repositioned. Moreover, in clinical practice, much focus has been given towards dressings that have been used to cover the ulcer. The complete treatment of DFU is still a farfetched dream to be achieved and it is expected that a combination therapy of herbal and synthetic drug with multiple treatment pathway could be able to overcome the disease.

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