scholarly journals Wagner’s Classification for Management and Evaluation of Diabetic Foot: A Prospective Study

2021 ◽  
Vol 8 (7) ◽  
pp. 327-331
Author(s):  
Prashant G.K. ◽  
Suryanarayan Reddy V
Keyword(s):  
Surgical Treatment ◽  
Glycemic Control ◽  
Diabetic Foot ◽  
Small Subset ◽  
Strict Glycemic Control ◽  
Foot Disease ◽  
Long Course ◽  
A Prospective Study ◽  
Keywords Antibiotics ◽  
Time Of Presentation

Background: In our community diabetes is one of the most common co-morbid illnesses. Out of its several complications in long course diabetic foot is one of them. Morbidity and mortality due to this complication is a major health issue. Objective: This study is undertaken for management and evaluation of foot ulceration to avoid amputation of lower extremities due to diabetic foot disease. Methods: This prospective observational study conducted between July 2019 and September 2020, 40 patients with diabetic foot admitted to Department of General Surgery, Chalmeda Anand Rao Institute of Medical Sciences, Karimnagar (TS) were subjected to surgical treatment depending upon the Wagner’s classification. Data was collected and analyzed by statistical software SPSS V 25. Results: Majority of the patients presented with higher grade and with poor glycemic control at the time of presentation. Conservative management with antibiotics was useful in a small subset of the patients. Majority of the patients needed surgical treatment in the form of debridement to amputations. Conclusion: Patient education and strict glycemic control can reduce the burden of diabetic foot. Early diagnosis and hospitalization, appropriate treatment including medical and surgical treatment according to the grade can reduce the morbidity mortality and improve the outcome of the disease. Keywords: Antibiotics; Amputation; Wagner classification; Complications; Glycemic control.

Surgical Treatment of Diabetic Foot Disease

2011 ◽  
Vol 12 (2) ◽  
pp. 88 ◽  
Author(s):  
Dong Yeon Lee ◽  
Il Young Kim
Keyword(s):  
Surgical Treatment ◽  
Diabetic Foot ◽  
Diabetic Foot Disease ◽  
Foot Disease

Critical limb ischaemia in diabetes: definition, assessment, prognosis

VASA ◽  
2001 ◽  
Vol 30 (Supplement 58) ◽  
pp. 21-27
Author(s):  
Luther
Keyword(s):  
Diabetic Foot ◽  
Laboratory Tests ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Clinical Use ◽  
Arterial Reconstruction ◽  
Arterial Circulation ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Fontaine Classification

In diabetic foot disease, critical limb ischaemia (CLI) cannot be precisely described using established definitions. For clinical use, the Fontaine classification complemented with any objective verification of a reduced arterial circulation is sufficient for decision making. For scientific purposes, objective measurement criteria should be reported. Assessment of CLI should rely on the physical examination of the limb arteries, complemented by laboratory tests like the shape of the PVR curve at ankle or toe levels, and arteriography. The prognosis of CLI in diabetic foot disease depends on the success of arterial reconstruction. The best prognosis for the patients is with a preserved limb. Reconstructive surgery is the best choice for the majority of patients.

Efficiency of application of silicate sorbents in surgical treatment of patients with neuro-ischemic form of diabetic foot ulcer

2019 ◽  
Author(s):  
Maksym Prystupiuk ◽  
Iuliia Onofriichuk ◽  
Lev Prystupiuk ◽  
Ludmila Naumova ◽  
Marianna Naumova
Keyword(s):  
Surgical Treatment ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer

scholarly journals Surgical Treatment of Diabetic Foot Ulcers Complicated by Osteomyelitis with Gentamicin-Loaded Calcium Sulphate-Hydroxyapatite Biocomposite

2021 ◽  
Vol 10 (2) ◽  
pp. 371
Author(s):  
Kor H. Hutting ◽  
Wouter B. aan de Stegge ◽  
Jaap J. van Netten ◽  
Wouter A. ten Cate ◽  
Luuk Smeets ◽  
...  
Keyword(s):  
Wound Healing ◽  
Surgical Treatment ◽  
Treatment Regimen ◽  
Diabetic Foot ◽  
Prospective Trial ◽  
Calcium Sulphate ◽  
Foot Ulcers ◽  
Ulcer Recurrence ◽  
Diabetic Foot Ulcers ◽  
Cox Regression Analysis

Diabetic foot ulcers, complicated by osteomyelitis, can be treated by surgical resection, dead space filling with gentamicin-loaded calcium sulphate-hydroxyapatite (CaS-HA) biocomposite, and closure of soft tissues and skin. To assess the feasibility of this treatment regimen, we conducted a multicenter retrospective cohort study of patients after failed conventional treatments. From 13 hospitals we included 64 patients with forefoot (n = 41 (64%)), midfoot (n = 14 (22%)), or hindfoot (n = 9 (14%)) ulcers complicated by osteomyelitis. Median follow-up was 43 (interquartile range, 20–61) weeks. We observed wound healing in 54 patients (84%) and treatment success (wound healing without ulcer recurrence) in 42 patients (66%). Treatment failures (no wound healing or ulcer recurrence) led to minor amputations in four patients (6%) and major amputations in seven patients (11%). Factors associated with treatment failures in univariable Cox regression analysis were gentamicin-resistant osteomyelitis (hazard ratio (HR), 3.847; 95%-confidence interval (CI), 1.065–13.899), hindfoot ulcers (HR, 3.624; 95%-CI, 1.187–11.060) and surgical procedures with gentamicin-loaded CaS-HA biocomposite that involved minor amputations (HR, 3.965; 95%-CI, 1.608–9.777). In this study of patients with diabetic foot ulcers, complicated by osteomyelitis, surgical treatment with gentamicin-loaded CaS-HA biocomposite was feasible and successful in 66% of patients. A prospective trial of this treatment regimen, based on a uniform treatment protocol, is required.

Current Concepts in Diabetic Microvascular Dysfunction

2006 ◽  
Vol 96 (3) ◽  
pp. 245-252 ◽  
Author(s):  
Javier La Fontaine ◽  
Lawrence B. Harkless ◽  
Christian E. Davis ◽  
Marque A. Allen ◽  
Paula K. Shireman
Keyword(s):  
Diabetic Foot ◽  
Vascular System ◽  
Microvascular Dysfunction ◽  
Diabetic Macroangiopathy ◽  
Patients With Diabetes ◽  
Foot Problems ◽  
Control Of Diabetes ◽  
Diabetic Foot Disease ◽  
Foot Disease ◽  
Pathologic Processes

Microvascular dysfunction is an important component of the pathologic processes that occur in diabetic foot disease. The endothelial abnormalities observed in patients with diabetes mellitus are poorly understood, and evidence suggests that endothelial dysfunction could be involved in the pathogenesis of diabetic macroangiopathy and microangiopathy. With the advent of insulin replacement in the early 1900s and increased efforts toward metabolic control of diabetes, long-term complications of this disease have become apparent. These late-term complications are primarily disorders of the vascular system. This article reviews the process of microvascular dysfunction and how it may relate to the pathogenesis of diabetic foot problems. (J Am Podiatr Med Assoc 96(3): 245–252, 2006)

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