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Category: Volume 06 Issue 08 August 2018
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Title: Aggressive Surgical Management in the Treatment of Diabetic Foot Ulcers

Authors: Dr Bammidi Sandeep. (M.S), Dr P.S. Srinivas, M.S (Gen)

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.106

Abstract

Aim of the Study

  1. To study the incidence of various foot lesions in diabetic foot patients attending to Malla Reddy Institute of Medical Sciences, Suraram X roads, Quthubullapur, Telangana
  2. To study the role of contributory factors in the initiation and perpetuation of the ulcer.
  3. To study the role of Hospital admission and aggressive surgical management in the treatment of diabetic foot ulcers.

Introduction

Diabetes mellitus is highly prevalent in India, with large share of diabetic persons called the “Diabetic Capital of the World” India and has an uphill task to care for its wide population. There were 31.7 million in 2000 cases of Diabetes in India and the figure is expected to rise further to 79.4 million cases by year 2030.1  The earliest manifestation of Diabetes, Tabes, Pernicious Anemia, Polycythemia, Metabolic disorders including Gout as well as vascular, Brain and spinal cord disorders are often seen in the foot. This is particularly true of Diabetes. 

References

  1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes Estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27:1047-53
  1. Boulton AJ. The diabetic foot: a global view. Diabetes Metab Res Rev 2000;16 (suppl 1):s2-5.
  2. Frykberg RG, Armstrong DG, GIurini J, Edwards A, KRavette M, Kravitz S, et al. Diabetic Foot   disorders: a clinical Pracice guideline. American college of Foot and Ankle Surgeons. J Foot Ankle Surg 2000;39 (5 suppl):s1-60.
  3. Reiber GE, Boyko EJ, Smith DG. Lower extremity foot ulcers and amputations in diabetes; In: National Diabetes Data Group (U.S.). Diabetes in America.2d ed. Bethesda, Md.: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1995;NIH publication no.95-1468.
  4. Resource from National Institute of Health (NIH) American Diabetes Association. Standards of medical care in diabetes -- 2010. Diabetes Care. 2008 Jan;33 Suppl 1:S11-61.
  5. Lavery LA, Ashry Hr, van Houtum W, Pugh JA, Harkless LB, Basu S. Variation in the incidence and proportion of diabetes-related amputations in minorities. Diabetes Care 1996;19:48-52
  6. Pecoraro RE, Reiber Ge, Burgess EM. Pathways to diabetic limb amputation. Basis for prevention. Diabetes care 1990;13:513-21.
  7. American Diabetes Association. Consensus Development Conference on Diabetic Foot Wound Care:  7-8 April 1999, Boston, Massachussets. Diabetes Care 1999;22:1354-60.
  8. Sumpio BE. Foot ulcers. NEJM 2000;343:787-93.
  9. Stevens Mj, Feldman El, Greene DA: The aetiology of diabetic neuropathy: The combined roles of metabolic and Vascular defects. Diabet Med 12:566,1995.59.
  10. Wilson RM. Neutrophil function in diabetes. Diabet Med 1986;6:509-12..
  11. McMahon MM, Bistrian BR. Host defences and susceptibility to infection in patients with diabetes mellitus.Infect Dis Clin North Am 1995;9:1-10.
  12. Sentochnik De, Eliopoluos GM. Infection and Diabetes. In, Joslin’s Diabetes Mellitus, 13th edition.CR Kahn and GC Weir, eds. Lea & Febiger (Philadelphia) 1994. Pages 867-68.
  13. Bridges RM, Deitch EA. Diabetic foot infections. Pathophysiology and treatment.  Surg Clin North Am 1994;74:537-635.
  14. Lipsky Ba. Infectious problems of the foot in diabetic patients. In, the Diabetic Foot, 6th edition., J.H. Bowker, M.A. Pfeifer, eds, St. Louis, Mosby, 2001, pages 467-80.
  15. Bokyo EJ, Ahoroni JH, Stensel V, Forsberg RC, Davignon DR, Smith DG. A prospective study of risk factors for diabetic foot ulcer: the Seattle Diabetic Foot Study. Diabetic Care 1999;22:1036-42.
  16. Reiber GE, Vileikyte L, Boyko EJ, del Agulia M, Smith DG, Lavery LA, et al. Causal pathways for incident lower-extremity ulcers in patients with diabetes from two settings. Diabetes Care 1999;22:157-62.
  17. Armstrong Dg, Lavery La. Diabetic foot ulcers:prevention, diagnosis and classification. Am Fam Physician 1998;57: 1325-32.
  18. McNeely MJ, Boyko EJ, Ahroni JH, Stensel VL, Reiber GE, Smith DG, et al. The independent contributions of diabetic neuropathy and Vasculopathy in diabetic foot ulceration. How great are the risks?Diabetes Care 1995;18:216-219
  19. Grayson ML, Gibbons GW, Balogh K, Levin E, Karchmer AW.Probing to bone in infected pedal ulcers: a clinical sign of underlying osteomyelitis in diabetic patients. JAMA 1995;273:721-32.

Corresponding Author

Dr P.S. Srinivas, M.S (Gen)

Associate Professor, ACSR Medical College, Nellore (A.P), INDIA