Clinical Utility of the Ankle-Brachial Index and Toe Brachial Index in Patients with Diabetic Foot Ulcers

2020 ◽  
Vol 16 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Mutasem Ababneh ◽  
Mousab Y. Al Ayed ◽  
Asirvatham A. Robert ◽  
Mohamed A. Al Dawish
Keyword(s):  
Diabetic Foot ◽  
Statistical Significance ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Cross Sectional Study ◽  
Screening Tests ◽  
Cross Sectional ◽  
Toe Brachial Index

Background: This cross sectional study investigated the clinical use of the ankle-brachial index (ABI) and toe brachial index (TBI) in 91 type 2 diabetic foot ulcer patients who visited the diabetic foot clinic, Prince Sultan Military Medical City, Saudi Arabia during July 2017 and January 2018. Materials and Methods: The ABI and TBI facilitated the detection of peripheral arterial disease (PAD) and the patients’ medical records were used to collect the clinical and demographic variables. The variables of duration (p = 0.047) and treatment (p = 0.046) of the ABI showed significant differences. Age (p = 0.034) and duration (p = 0.001) were the factors related to the diagnosis of TBI by the “χ2” test. Results: From the TBI, 26.4% of the patients were found to have PAD, while the ABI showed that 21.8% of patients had the condition. However, no statistical significance was noted. From the regression analysis, the variable duration of diabetes (≥ 20 years of age) was recognized as an independent risk factor for TBI. Conclusion: In conclusion, it is recommended both the ABI and TBI to be used as screening tests for PAD in diabetic foot ulcer patients.

scholarly journals Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Tesfamichael G. Mariam ◽  
Abebaw Alemayehu ◽  
Eleni Tesfaye ◽  
Worku Mequannt ◽  
Kiber Temesgen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Care Practice ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.

scholarly journals Factors associated with wound healing outcome among Diabetic Foot patients- A cross sectional Study

2021 ◽  
Vol 5 (1) ◽  
pp. 36-46
Author(s):  
M Jayalakshmi ◽  
P Thenmozhi
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Wound Management ◽  
Diabetic Patients ◽  
Foot Care ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
One Year

Diabetic foot ulcer (DFU) has been identified as the leading reason for hospitalization among patients with diabetes. Patients with diabetes are at greater risk of complications, the most important of them are diabetic neuropathy and peripheral vascular disorders leading to the development of foot ulcers. The problem is generally faced and as well is considered as one among the most common complications of diabetes that affect millions of people all over the world. The current study, aimed to document the clinical profile and healing outcome of diabetic foot ulcer management which may become guidance for further improvement in wound management among diabetic foot ulcer patients. Cross sectional descriptive study was conducted over one-year period of time. A total of 246 Diabetic patients with a foot ulcer of Grade 1 to 3 participated in the study. Patients with higher grade ulcers of Grade 4 and 5 were excluded from the study. Final data analysis of 160 patients was done using SPSS version 20. The prevalence of Grade 2 and 3 ulcers were observed 54.37% and 31.8 % while Grade 1 ulcer was observed 13.75%. No risk factors were found to be significantly associated with diabetic foot ulcer. Wound was healed well in 50 % and partially healed in 21 % of the participants. Wound remains unchanged in 3 % of study participants, while 8% of participants underwent toe amputation. Foot ulceration is a preventable in many diabetic patients with adequate education, routine foot care and attention to foot wear.

scholarly journals Chronic Sorrow Dan Quality Of Life Pada Pasien Dengan Diabetic Foot Ulcer (DFU)

2020 ◽  
Vol 14 (2) ◽  
pp. 197-205
Author(s):  
Putri Puspitasari
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Chronic Sorrow ◽  
Sectional Study ◽  
Cross Sectional

Pendahuluan : Diabetic Foot Ulcer (DFU) merupakan komplikasi jangka panjang yang umum ditemukan pada pasien Diabetes Mellitus (DM). Penurunan kualitas kesehatan, proses penyembuhan yang lambat, ancaman amputasi, serta ancaman kematian berdampak terhadap keadaan psikologis yang buruk bagi penderita DFU. Keadaan emosi yang mungkin timbul pada pasien dengan penyakit kronis seperti DFU adalah perasaan chronic sorrow dan Quality Of Life yang kurang baik. Tujuan dari penelitian ini adalah melihat keadaan chronic sorrow dan quality of life pada pasien dengan DFU serta secara spesifik melihat hubungan antara chronic sorrow dengan quality of life pasien dengan DFU Metode Penelitian: Penelitian ini merupakan jenis penelitian kuantitatif dengan desain analytic correlative dan rancangan penelitian menggunakan pendekatan cross sectional study. Tujuan penelitian ialah untuk menganalisis hubungan antara chronic sorrow dan kualitas hidup pada pasien dengan DFU. Sampel penelitian adalag 46 Responden. Hasil dan kesimpulan: hasil penelitian menunjukan dari 46 responden 29 (63,04 %) mengalami keadaan chronic sorrow dan diantara 46 responden 27 (58,7 %) mengalami keadaan kualitas hidup yang kurang baik. Responden yang mengalami chronic sorrow memiliki kualitas hidup yang kurang baik sebesar 78,13 % dan kualitas hidup yang baik sebesar 21,87 % dengan p= 0,000 lebih kecil dari α= 0,05, yang dapat diartikan bahwa terdapat hubungan bermakna antara keadaan chronic sorrow dan quality of life.

Prevalence of Peripheral Arterial Disease in Diabetic Foot Ulcer Patients and its Impact in Limb Salvage

2021 ◽  
pp. 153473462110270
Author(s):  
Ahmed Azhar ◽  
Magdy Basheer ◽  
Mohamed S. Abdelgawad ◽  
Hossam Roshdi ◽  
Mohamed F. Kamel
Keyword(s):  
Peripheral Arterial Disease ◽  
Limb Salvage ◽  
Diabetic Foot ◽  
Negative Impact ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Arterial Disease ◽  
Limb Amputation ◽  
Cross Sectional ◽  
Peripheral Arterial

Diabetic foot ulcer syndrome is a common complication of diabetes mellitus. Three main factors contribute to it: neuropathy, vasculopathy, and infection. This study was conducted to evaluate the prevalence of peripheral arterial disease (PAD) in diabetic foot ulcer patients and its impact on limb salvage as an outcome. This prospective cross-sectional study included 392 cases, who were divided according to the presence of PAD into 2 groups; patients with PAD were labeled as PAD +ve (172 cases) and those without PAD were labeled as PAD −ve (22 cases). All cases were clinically assessed, and routine laboratory examinations were ordered. Moreover, duplex ultrasound was done for suspected cases of having PAD by examination. Computed tomography angiography was ordered for patients who are in need of a revascularization procedure. Cases were managed by debridement and/or revascularization. After that, these cases were assessed clinically and radiologically for vascularity and infection and the possibility for amputation was evaluated. Infection was classified using Wagner Classification System, and revascularization was decided according to the TASC II system. The incidence of PAD in cases with diabetic foot ulcer syndrome was 43.87%. No difference was detected between the 2 groups regarding age and gender ( P > .05). The prevalence of smoking, hemodialysis, ischemic heart disease (IHD), and hypertension was more significantly higher in cases with PAD ( P < .05). Revascularization procedures were only performed in cases that had documented severe PAD or chronic limb-threatening ischemia in addition to foot ulcer and/or infection. With regard to limb salvage, it was more significantly performed in cases without PAD (82.3% vs 48.3% in PAD cases; P < .001). Male gender, smoking, ankle-brachial pressure index, hemodialysis, IHD, neuropathy, HbA1C, PAD, and high Wagner classification were predictors of limb amputation ( P < .05). PAD is associated with worse outcomes in diabetic foot ulcer patients. Not only does it constitute a great number among diabetic foot ulcer patients, but it also has a negative impact on limb salvage.

scholarly journals A one year cross sectional study on role of Wagner’s classification in predicting the outcome in diabetic foot ulcer patients

2018 ◽  
Vol 5 (7) ◽  
pp. 2537
Author(s):  
Praveena D. L. ◽  
Shashi M. Uppin ◽  
S. S. Shimikore
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional Study ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Cross Sectional ◽  
Grade Ii ◽  
One Year

Background: Diabetes mellitus-related foot ulceration is very common. Several classification systems for diabetic foot ulcers have been proposed. The present study was intended to assess the role of Wagner wound classification in predicting the outcome of diabetic foot ulcer and also know the grade of Wagner’s classification to which majority of diabetic foot ulcer patients.Methods: This present one year cross sectional study was carried out at the Department of General Surgery. A total of 100 patients with diabetic foot ulcer who presented during the study period were included. The diabetic foot ulcers were graded according to the Wagner’s classification. The relative risk of amputation in different grades of diabetic foot ulcer based on Wagner classification was determined.Results: In this study majority of the patients were males (79%) and the male to female ratio was 3.76:1. The mean age was noted as 55.8±10.45 years. Majority of the patients had duration of ulcer less than one month (88%). Surrounding skin was inflamed in 60% of the patients, necrosis was present in 40% and slough was noted in 98% while 44% of the patients had necrotic tissue. Based on Wagner’s Classification, most of the patients (48%) had Grade II diabetic foot ulcers. With regard to management, in 44% of the patients’ debridement was done and 36% of the patients had disarticulation or amputation in 36%. Of the 48 patients with grade II ulcer, 79% of the patients had healing without amputation. Of the 58 patients with grade I and II diabetic foot ulcers, 82.76% had healing without amputation compared to 17.24% of the patients who needed amputation. Patients with Grade III, IV and V had 3.59 times higher risk of amputation compared to patients with grade I and II. (p<0.001; 95% CI- 1.95 to 6.62).Conclusions: Grading of diabetic foot ulcer based on Wagner’s classification affects and predicts the outcome and the risk of amputation increases with increasing grade. Most of the patients admitted for diabetic foot ulcers in our hospital belonged to Wagner’s grade II (48%).

scholarly journals Correlation between Serum Level of Vitamin D and Severity Degree of Diabetic Foot Ulcer in Patients with Normal Ankle Brachial Index

2019 ◽  
Vol 1 (1) ◽  
pp. 34-36
Author(s):  
Saleh Harris ◽  
Raden Suhartono ◽  
Aria Kekalih
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Serum Level ◽  
Diabetic Foot ◽  
Ankle Brachial Index ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cross Sectional ◽  
Vitamin D Levels ◽  
Severity Degree

Introduction: Diabetes mellitus can cause various complications, including diabetic foot ulcers (DFU). Vitamin D levels are known to be correlated with wound healing and insulin resistance. Method: This cross-sectional study aimed to determine the correlation between the serum level of vitamin D and the severity degree of DFU. Thirty DFU patients with normal ankle- brachial index, grouped into degrees according to the Wagner classification, were included in this study. Their serum level of vitamin D was examined using the chemiluminescent immunoassay method. The correlation between these two variables was analyzed. Results: Patients were 18 males (60%) and 12 females (40%) with an average age of 57 years. The average serum level of vitamin D was 10.58 ng/mL. A significant correlation was found between the serum level of vitamin D and the severity of DFU (r= -0.901, p <0.001). Conclusion: The serum level of vitamin D screening in DFU patients was strongly correlated with the degree of DFU. Keywords: diabetes mellitus, diabetic foot ulcer, vitamin D, Wagner classification

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