Evaluation of age and peripheral vascular disease as risk factors for diabetic foot ulceration among Nigerian patients without foot ulcers.

2011 ◽  
Vol 12 (2) ◽  
Author(s):  
OC Oguejiofor ◽  
JM Oli ◽  
CU Odenigbo ◽  
CBN Oguejiofor
Keyword(s):  
Risk Factors ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Peripheral Vascular ◽  
Foot Ulceration

scholarly journals A study of association of Diabetic Foot Ulcers and Peripheral Vascular Disease

2018 ◽  
Vol 5 (6) ◽  
pp. 1454 ◽  
Author(s):  
Yasmee Khan ◽  
Manal M. Khan ◽  
Aakansh Jain ◽  
Rohit K. Namdev
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Diabetic Foot ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Peripheral Vascular ◽  
Early Management ◽  
Duration Of Diabetes ◽  
Presenting Symptoms ◽  
Ischemic Ulcers

Background: Diabetic foot ulcers (DFU) are a common, costly, complex, and disabling complication of diabetes resulting in lower-extremity amputations. Diabetes Mellitus (DM) is associated with an increase in the incidence of peripheral vascular disease (PVD) compared to non-diabetic subjects. DFU are divided into two types: neuropathic ulcers (NPU) and neuro-ischemic ulcers (NIU). PVD in association with neuropathy leads to neuro-ischemic ulcers (NIU).Methods: A cross-sectional observational study was conducted for eighteen months period from October 2016 to March 2018, on 120 type-2 DM patients presenting with DFU at tertiary centre in central India. Informed written consent, detailed history was obtained from the patients including duration of diabetes, history of hypertension, smoking, presenting symptoms and other complications related to diabetes. Examination of foot and evaluation for peripheral pulses, ankle brachial pressure index (ABI), neuropathy and blood pressure were done. Laboratory tests for HbA1C, lipid profile, blood urea, serum creatinine and urine albumin creatine ratio (urine ACR) were done. Statistical analysis used: t test, fisher exact test and univariate analysis.Results: In our study, 1594 patients with T2DM were studied, out of which 120 patients presented with new DFU. Mean age of the patients was 61.5years with an M: F ratio of 1.78:1. NIU was present in 36 and NPU in 84 out of 120 DFU patients. Neuro-ischemic ulcers (NIU) were more common among males (28/78 males vs 8/42 females). NIU was found to have significant association with smoking (25/36 patients), hypertension (28/38 patients) and longer duration of diabetes (13.1 vs 9.2years). Other diabetic complications, retinopathy (26/36 patients) and nephropathy (18/36 patients) were more prevalent in patients with NIU. Dyslipidemia was also found in 58.33% (21/36) patients with NIU however the association was insignificant.Conclusions: Diabetic foot ulcers are very debilitating complication of diabetes, and a leading cause of amputations all over the world. Because of increased association of peripheral vascular disease with diabetic foot ulcers there is a rise in prevalence of neuro-ischaemic ulcers. Early management of peripheral vascular disease is important to prevent development of neuro-ischaemic ulcers.

scholarly journals Comparison of negative pressure wound therapy with moist wound therapy in the treatment of diabetic foot ulcers with non-revascularisable peripheral vascular disease

2017 ◽  
Vol 4 (7) ◽  
pp. 2173
Author(s):  
Someshwara Rao Narayana Pallela ◽  
Padmavathi Narahari
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Foot Ulcers ◽  
Control Group ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Wound Therapy

Background: Diabetic foot problems are the commonest reason for hospitalization of diabetic patients (about 30% of admissions) and absorb some 20% of the total health-care costs of the disease more than all other diabetic complication. The numbers of patients with chronic wounds and wound complications continues to increase. Wound management is a challenge in diabetic wound. Chronic wounds require significant medical, nursing and financial input with poor long-term results. One-third of all diabetic patients have significant peripheral neuropathy and/or peripheral vascular disease (PVD). In India prevalence of foot ulcers in diabetic patients in clinic population is 3%. Over the past several years negative pressure wound therapy (NPWT) using vacuum- assisted closure has emerged as the treatment of complex wounds of the diabetic foot. Many reports on the use of Vacuum Assisted Closure (VAC) therapy after failed revascularization have found increased chances of success. Clinicians should consider negative pressure wound therapy as an adjunct to other modalities in an effort to avoid complications.Methods: Total of 51 patients were included in this prospective study. They were randomly divided into two groups, negative pressure wound therapy (NPWT) group (25 patients) and control group (26 patients) who were treated with regular dressings. All the patients included had peripheral vascular disease which was declared non-revascularisable after vascular workup. Initial mean surface area was measured in each patient. Transcutaneous oxygen pressure was recorded in all the patients and each patient followed up based on their granulation tissue development and need for amputation in each group.Results: After wound management, mean surface area of the diabetic wounds was 39.08cm2 in the NPWT group (P=0.019), and 38.63cm2 in the control group (P=0.327). The use of NPWT may be an effective initial wound therapy to achieve faster wound bed granulation showing signs of healing in 19 among 25 patients (76%) compared to control group 7 showed granulation among 26 patients (26%) (P=0.001). The incidence of secondary higher amputation in NPWT group is 6/25 (24%), the control group 17/26 (65%) (P=0.003), suggesting reduced incidence of secondary higher amputations in NPWT group. After treatment, the experimental group significantly improved in measures of foot ulcer surface area compared with the control group. Further studies are needed to clarify the effects and indications and to modify the technique of this alternative treatment for use on non healing wounds.Conclusions: NPWT-treated patients reached a successful wound treatment endpoint more rapidly, and the benefit was apparent in all wound sizes. NPWT appears to be a safer and efficacious method, than moist wound therapy for the treatment of diabetic foot ulcers. 

scholarly journals Prevalence of Peripheral Vascular Disease in Diabetic Foot Infections and its Effect on Management Outcome

2019 ◽  
Vol 38 (1) ◽  
pp. 12-17
Author(s):  
Farah Nobi ◽  
Syed Al Nahian ◽  
Afrin Sultana ◽  
Rokhsana Sarmin ◽  
Ayesha Rahman ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Lower Limb ◽  
Diabetic Foot ◽  
Tertiary Care ◽  
Peripheral Vascular ◽  
Tertiary Care Centre ◽  
Term Care ◽  
Diabetic Foot Infection ◽  
Diabetic Foot Infections

Background: Foot infection is a common problem affecting diabetics. Ischemia is a major factor contributing to progress and morbidity of the disease. The prevalence of peripheral vascular disease is higher in diabetics with faster progression. Aim: This study aimed to observe the prevalence of peripheral vascular disease in patients with diabetic foot infections presenting to this tertiary care centre. Methods: This prospective observational study evaluated 250 patients with diabetic foot infection admitted to Ibrahim Medical College and BIRDEM General Hospital, Dhaka, from 1st January 2015 to 31st December 2015.Total 72 patients were selected for Duplex study of lower limb vessels, Ankle Brachial Pressure Index (ABPI) and Pulse oxymetrywhich established the diagnosis of peripheral vascular disease and all patients were treated according to the standard protocol. Results: Of the 72 patients peripheral vascular disease was found in 25 patients (34.7%) and majority of them (88%) had distal below the knee vessel stenosis. There was significant correlation with older age (75%) and history of tobacco use (64%). The clinical presentations and outcomes such as hospital stay, healing time, pain were worse in individuals with peripheral vascular compromise on Duplex study of lower limb vessels, ABPI and pulse oxymetry. Conclusion: In this study we observed that significant number of diabetics presenting with foot infections have underlying peripheral vascular disease .The patients might not all be symptomatic or show obvious signs of PVD but need to be investigated for the same. Early detection of peripheral vascular disease in patients presenting with diabetic foot infection, using Duplex study,ABPI and Pulse oxymetrywith routine clinical and laboratory assessment can be of great value in long term care of these individuals. J Bangladesh Coll Phys Surg 2020; 38(1): 12-17

Comparative Histopathology of Radial Artery Versus Internal Thoracic Artery and Risk Factors for Development of Intimal Hyperplasia and Atherosclerosis

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Permyos Ruengsakulrach ◽  
Roger Sinclair ◽  
Masashi Komeda ◽  
Jai Raman ◽  
Ian Gordon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Radial Artery ◽  
Morphometric Analysis ◽  
Intimal Hyperplasia ◽  
Internal Thoracic Artery ◽  
Peripheral Vascular ◽  
Luminal Narrowing ◽  
Intimal Thickness

Background —In this study, we examined the comparative histopathology, morphometry, and risk factors for the development of intimal hyperplasia and atherosclerosis in the radial artery (RA) and the internal thoracic artery (ITA). Methods and Results —Paired specimens of RAs and ITAs, obtained from 150 patients who underwent CABG, were evaluated with histopathology; 110 pairs of arteries were suitable for morphometric analysis. The severity of disease was evaluated on the basis of percentage of luminal narrowing, intimal thickness index, and intima-to-media ratio. Risk factors were determined with stepwise linear regression. Intimal hyperplasia was seen in 141 RAs (94%) and 103 ITAs (69%) ( P <0.001). Atherosclerosis was seen in 5% of RAs and 0.7% of ITAs ( P =0.04). Medial calcification was found only in RAs (20 of 150, 13.3%) ( P <0.001). Morphometric analysis showed that compared with ITAs, RAs had a significantly higher intimal area, medial area, percentage of luminal narrowing, intimal thickness index, and intima-to-media ratio (all P <0.001) Factors found to be significant ( P <0.05) predictors of the 3 severity indices of intimal hyperplasia, including atherosclerosis, in RAs were peripheral vascular disease, smoking, age, and diabetes. Risk factors for intimal hyperplasia in ITAs were age and smoking. Conclusions —The RA is more likely to have atherosclerosis, intimal hyperplasia, and medial calcification than the ITA. Morphometric analysis indices showed marked differences between the RA and the ITA. Care should be taken when selecting the RA as a conduit in CABG, particularly in patients who are elderly, diabetic, smoke, or have peripheral vascular disease.

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