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.

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.

scholarly journals A clinicopathogical study on diabetic foot ulcer with special reference to the causative factors and its management

2019 ◽  
Vol 6 (5) ◽  
pp. 1540
Author(s):  
Sailendranath Paul ◽  
Dilip Kumar Das
Keyword(s):  
Diabetic Foot ◽  
Age Of Onset ◽  
Management Strategies ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Major Amputation ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
E Coli ◽  
Related Risk

Background: Diabetic ulcers are the most common foot injuries leading to lower extremity amputation. The present study was done to identify the incidence and related risk factors of diabetic foot ulcers in study participants.Methods: This was a prospective done on 50 patients with diabetic foot ulcers. All the patients were examined thoroughly and related laboratory investigations were done. Wound culture and sensitivity was done in all cases.Results: Mean age of onset with foot ulcers was 53.5 yrs in male and 55 yrs in females. Nephropathy was present in 12 (24%) patients. Sensorimotor neuropathy was present in 29 (58%) cases and autonomic neuropathy was present in 06 (12%) cases. Most common infection identified in diabetic foot ulcers was due to gram-negative bacteria (E. coli in 45 cases). Major amputation was done in 2 (4%) patients.Conclusions: Implementation of management strategies at early stages prevents the development of complications related to diabetic foot ulcers in patients. 

scholarly journals A prospective observation study on diabetic foot ulcer using diabetic ulcer severity score at tertiary care hospital

2021 ◽  
Vol 8 (12) ◽  
pp. 3553
Author(s):  
Bharti Saraswat ◽  
Kapil Kumar Gill ◽  
Ashok Yadav ◽  
Krishan Kumar
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Scoring Systems ◽  
Foot Ulcers ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Age Group ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer

Background: A number of scoring systems and classifications are available for diabetic foot ulcers with intention to compare the treatment modalities and future outcomes. Many of them are complex and don’t predict future outcome within the patients. Aim and objectives of current study were to establish a wound-based clinical scoring systems (DUSS) as daily clinical practice by assessing the efficacy of diabetic ulcer severity score.Methods: A total of 73 diabetic patients with foot ulcers were included in this prospective observational study conducted at Dr. S.N. Medical college, Jodhpur and attached hospitals from July 2018 to August 2020. Ulcers were assessed and DUSS score created. Patients were followed up for six months or until healing or amputation if either.Results: In this prospective study of 73 patients with diabetic foot ulcers, most common age group affected was between 51-70 years. Mean age group was 58.57±12.66 years. Mean duration of diabetes was 7.61±5.72 years. Most commonly ulcers were of DUSS score 2. Mean DUSS score was 1.97±1.15. Majority of diabetic foot ulcer patients (37 out of 51) with DUSS score 0, 1 and 2 healed by primary intention after wound debridement. Those with score 3 & 4 majority of them (20 out of 22) had amputation.Conclusions: This is a very simple scoring system that provides an easily accessible and a streamlined approach in the clinical setting without need of any advanced investigative equipment. Hence this can be applied in any set up.

scholarly journals Monitoring and Prevention the Risk of Diabetic Foot Ulcer Infection during Coronavirus Disease-19 Pandemic: A Narrative Review and Perspective Algorithm

2021 ◽  
Vol 9 (B) ◽  
pp. 577-582
Author(s):  
Mariya Dmitriyeva ◽  
Saken K. Kozhakhmetov ◽  
Dulat K. Turebayev ◽  
Saltanat N. Urazova ◽  
Talgat M. Omarov ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cochrane Library ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
Number Of Patients ◽  
Increased Risk

BACKGROUND: The coronavirus disease (COVID)-19 pandemic leads to significant changes in the healthcare system and undermining best practices for maintaining a diabetic limb. A large number of patients with diabetic foot are left without timely medical care and are at increased risk of complications, hospitalization, lower limb amputation, and death. A new paradigm must be adopted for the transition from inpatient care to community-based care. The introduction of a pandemic remote management for patients with diabetic foot ulcer includes an assessment of the risk of complications through telemedicine and further stratification of patients according to the developed algorithm. METHODS: A literature review was performed for articles related to telemedicine. We used PubMed, Google Scholar, Cochrane Library, and Ovid MEDLINE to search published articles. We used the following keywords: “Telemedicine,” “diabetes mellitus,” “COVID-19,” “diabetic foot ulcer,” and “remote monitoring.” RESULTS: Implementation of the proposed pandemic care includes telemedicine for remote monitoring and treatment of patients with diabetic foot ulcers, as well as an algorithm for determining the risk of diabetic ulcer infection and patient management tactics according to the identified risk. CONCLUSION: The management of patients with diabetic foot ulcers during a pandemic includes the following goals – to reduce the burden on the health-care system, maintain the safety and functionality of diabetic foot at home, and reduce the risk of COVID-19 in patients with diabetic foot ulcers.

scholarly journals Correlation of Peak Systolic Velocity Value with Wagner Score in Diabetic Foot Ulcer patients in RSUP Dr. M. Djamil Padang

2021 ◽  
Vol 5 (4) ◽  
pp. 1206-1211
Author(s):  
Fernando Laroza ◽  
Raflis Rustam ◽  
Vendry Rivaldy
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Peak Systolic Velocity ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Diabetic Ulcer ◽  
Negative Direction ◽  
Correlation Strength ◽  
Normally Distributed

Background: Diabetic foot ulcers are one of the chronic complications of diabetes mellitus (DM) in the form of wounds on the skin surface of the feet of DM patients accompanied by internal tissue damage or tissue death, either with or without infection, which is associated with the presence of neuropathy and or peripheral arterial disease in patients with DM. The World Health Organization (WHO) states that at least 422 million people suffer from DM A new alternative parameter for assessing the degree of peripheral ischemia is ankle peak systolic velocity (PSV). The rationale for PSV is based on the observation that in the ischemic limb, blood travels at a much slower rate in the distal leg arteries than in the nonischemic limb. PSV is a quick and easy test to assess the patient's vascular status and monitor the development of diabetic foot ulcers, and can assess the degree of ischemia and predict healing of diabetic foot ulcers. This study aims to determine the Correlation of Peak Systolic Velocity Value with Wagner Score in Diabetic Foot Ulcer patients in RSUP Dr. M. Djamil Padang. Methods: This research is analytic observational with cross sectional design, the research uses primary data. This research will be conducted at the RSUP Dr. M. Djamil Padang from July 2021 to October 2021. The population in this study were diabetic foot ulcer patients who came for treatment at Dr. M. Djamil Padang. A sample of 32 patients Diabetic foot ulcer met the inclusion criteria. Univariate analysis was conducted to describe each of the variables studied. Numerical data is normally distributed, then it is presented in the form of mean ± standard deviation (SD), whereas if the numerical data is not normally distributed then it is presented in the form of median, minimum and maximum. Categorical data is presented in the form of frequency and percentage of each category. Bivariate analysis was started by using the data normality test using the Shapiro Wilk test (n<50). In testing the correlation between Peak Systolic Velocity and Wagner Score in diabetic foot ulcer patients, the Pearson correlation test is used if the data is normally distributed. Data analysis using SPSS version 22.0. Results: more than half of the subjects (65.6%) are male. The mean age of the subjects was 60.46±10.06 years. More than half of the subjects (62.5%) had a normal body mass index. The average length of suffering from diabetes mellitus was 5.48 ± 2.26 years. Half had a history of smoking (59.4%), a small proportion of subjects had hypertension (21.9%), hypercholesterolemia (6.3%) and neuropathy (12.5%). More than half of the subjects (53.1%) had immunopathies. There is a correlation between the popliteal PSV value and the Wagner score in diabetic ulcer patients (p<0.05), with a moderate correlation strength (r=-0.463) and a negative direction. There is a correlation between the PSV dorsali pedis value and the Wagner score in diabetic ulcer patients (p<0.05), with a strong correlation strength (r=-0.720) and in a negative direction. Furthermore, there is a correlation between the posterior tibial PSV value and the Wagner score in diabetic ulcer patients (p<0.05), with a moderate correlation strength (r=-0.530) and a negative direction. Conclusion: There is a correlation between the popliteal, tibialis posterior, dorsalis pedis PSV value and the Wagner score in diabetic foot ulcer patient

scholarly journals Drugs abuse and increase in referral to hospital to prevent recurrence of diabetic foot ulcer infection

2019 ◽  
Vol 10 (1) ◽  
pp. 89-94
Author(s):  
Mostafa Madmoli ◽  
Yaghoob Madmoli ◽  
Fariba Mobarez ◽  
Hosein Taqvaeinasab ◽  
Pouriya Darabiyan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Drug Abuse ◽  
Significant Relationship ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Patients With Diabetes ◽  
History Of

Introduction: Diabetic foot ulcer is one of the complications of diabetes. This study was aimed to determine drugs abuse and increase in referral to hospital to prevent recurrence of diabetic foot ulcer infection. Materials and Methods: In this retrospective cross-sectional analytical descriptive study, 1693 patients with diabetes between 2015-17 were enrolled. Files of this number of diabetic patients admitted to khatam-ol-Anbia hospital in shoushtar city were studied. Data were entered into SPSS software version 18 and analyzed using descriptive statistics, analytical tests. Results: In this study 1693 patients with diabetes mellitus with a mean age of 52.13 ± 53.22 years. In the case of diabetic foot ulcers, 9.5% of the patients had diabetic foot ulcers and 4.8% had a history of amputation and 2.4% of the patients had a history of surgery on their diabetic ulcer. In this study, a significant relationship was found between education level and diabetic foot ulcer (p <0.003). Also, there was a significant relationship between limb amputation and drug abuse or smoking (P = 0.009). In this study, patients who had drug and smoking or smoking 4.3% more than those who did not consume, they were referred to the hospital to prevent recurrence of foot ulcer infection. In this study, there was a significant relationship between drug abuse or smoking and the rate of surgery in diabetes mellitus (P = 0.007). Conclusion: Given that in this study, patients who had drug and smoking or smoking 4.3% more than those who did not consume, they were referred to the hospital to prevent recurrence of foot ulcer infection. In this study, there was a significant relationship between drug abuse or smoking and the rate of surgery in diabetes mellitus. Therefore, there is a suggestion to reduce the consumption or abandonment of drugs and smoking.  

scholarly journals Identification of biofilm-producing microorganism’s and drug susceptibility pattern from diabetic foot ulcer patients at Puducherry

2020 ◽  
Vol 11 (4) ◽  
pp. 7353-7357
Author(s):  
Jayarani Manikandan ◽  
Jaikumar S ◽  
Sandhya Rani T
Keyword(s):  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Isolation And Identification ◽  
Diabetic Ulcer ◽  
Biofilm Production

Diabetes mellitus is a significant health problem worldwide that affects approximately 171 million people; severe complications lead to the development of diabetic foot ulcers. Diabetic ulcer infections are mainly polymicrobial in nature and multidrug-resistant (MDR), which is capable of forming a biofilm, which is the important virulence factor results in treatment failure. The main objectives of this study to investigate the etiologic agents of diabetic foot infections, their antimicrobial resistance and biofilm formation. A total of 200 patient samples were taken from diabetic foot ulcer patients between September 2015 and February 2016. Isolation and identification of microorganism were made according to standard microbiological procedures. Antibiotic Susceptibility testing performed by Kirby Bauer disc diffusion method and the biofilm production was performed by the tube method and Congo Red Method. Out of 200 samples processed,  110 (55%) were polymicrobial, 50 (25%) monomicrobial and 40(20 %)culture Sterile. The most common organism isolated were 82(39%) Pseudomonas aeruginosa,45(21%) Staphylococcus aureus, 48(23%) Candida sp followed by others. Biofilm production was seen in 112 (53%) of the isolates. Antimicrobial drug  resistance was higher among 92(82%) biofilm producers than non-biofilm 20(18%) producing microorganisms. Organisms isolated from chronic diabetic foot ulcers cases were multidrug-resistant and biofilm producers. Our study shows the importance of biofilm screening with the usual antibiogram, as a routine technique in diabetic foot ulcers patients for effective treatment.

scholarly journals Cutaneous squamous carcinoma in a patient with diabetic foot: an unusual evolution of a frequent complication

2018 ◽  
Vol 2018 ◽  
Author(s):  
Alessandro Mantovani ◽  
Ilaria Teobaldi ◽  
Vincenzo Stoico ◽  
Fabrizia Perrone ◽  
Marina Zannoni ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Cutaneous Squamous Cell Carcinoma ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

Summary After basal cell carcinoma, the cutaneous squamous cell carcinoma (cSCC) is the second most frequent non-melanoma skin cancer worldwide, and, classically, arises from the upper coats of the epidermis of sun-exposed areas or from skin areas constantly exposed to a chronic inflammatory stimulus. The occurrence of cSCC seems to be linked to several factors, including exposure to sunlight (or other ultraviolet radiations), immunosuppression, chronic scarring conditions and some familial cancer syndromes. Although the majority of cSCCs are adequately eradicated by surgical excision, a subgroup of cSCC may be linked with an increased risk of recurrence, metastasis and death. The incidence of type 2 diabetes mellitus is constantly increasing worldwide. Importantly, diabetes mellitus is a strong risk factor for cancers (including cutaneous tumors) and is highly related with poor cancer outcomes. At present, in the literature, squamous cell carcinoma developing in association with diabetic foot ulcers has been already reported in some reports; however, additional data are needed to make the clinicians aware of this rare, although possible, complication. Therefore, we herein report an unusual case of an elderly man with T2DM and a positive oncological history, presenting a cSCC involving the skin overlying the first toe of left foot. The growing cSCC appeared approximately 3 years after the appearance of a diabetic ulcer. Learning points: Diabetic foot ulcers are an important and severe complication of diabetes mellitus and often can result in foot amputation. Chronic and non-healing diabetic foot ulcers are often observed in clinical practice. Clinicians should always take into consideration the malignant degeneration (e.g., cutaneous squamous cell carcinoma) of any chronic non-healing diabetic foot ulcer in elderly T2DM individuals. Timely surgical resection of a chronic, non-healing diabetic foot ulcer might preclude the development of a cutaneous squamous cell carcinoma.

Lachesis mutus and Calendula officinalis Q in Diabetic Foot Ulcer Treatment–Two Case Reports

2021 ◽  
Vol 34 (02) ◽  
pp. 164-174
Author(s):  
K. C. Muraleedharan ◽  
Pooja Prakash
Keyword(s):  
Diabetic Foot ◽  
Case Reports ◽  
Financial Burden ◽  
Bipolar Affective Disorder ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Calendula Officinalis ◽  
Diabetic Ulcer

AbstractDiabetic foot ulcers and its complications are to be dealt cautiously in general medical practice. Most cases of diabetes mellitus have multiple comorbidities which add more difficulty in ulcer management. The chances of complete wound healing are low even after amputation, which may be required in >15% of patients with diabetic ulcer. Furthermore, it leaves behind mental, physical and financial burden to people. In this case report, two cases of diabetic foot ulcers are presented, one with bipolar affective disorder and the other one with his toes amputated, which were treated with homoeopathic medicines Lachesis mutus and Calendula officinalis Q along with standard care in an inpatient department facility. It shows the effectiveness of homoeopathy in managing such challenging cases without complication.

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.

Sign in / Sign up

Export Citation Format

Share Document