| dc.description |
Background: Diabetic foot ulcer is one of the most serious complications of diabetes mellitus. As the global burden of diabetes mellitus is increasing, the incidence of diabetic foot is equally on a rise. However, diabetic foot has been often ignored by people and also the treating physicians leading to a rise in more complication. Hence, diabetic foot classification becomes very important as an early predictor of diabetic foot outcome.
Aim: To determine the severity by using Wagner’s classification and outcome of diabetic foot ulcer among patient admitted at KCMC 2015.
Methodology: This was a descriptive cross-sectional hospital based study, secondary data form medical record for patient admitted for diabetic foot ulcers was used to obtain important information for the study.
Results. Out of 102 patients, 72 (70.6%) were male. Their age ranged from 19-95 years with mean age of 55.11 years, Most of patients in this study 31(30.4%) were aged between 51-60 years, 91(89.2%) were unemployed in formal sector, 84(82.4%) were nonsmoker and 35(34.5%) were alcohol user. The majority of patients had uncontrolled diabetes indicated by high blood sugar 93 (91.2%) had fasting blood sugar of more than 7.6mmol/L, the maximum and minimum levels were 200.0mmol/L and 3.3mmol/L respectively, more than half of patients 62 (60.8%) had normal blood pressure,92 (90.2%) of patient were type 2 Diabetes mellitus and 10(9.8%) were type 1 Diabetes mellitus, 58(56.9%) of the patients with diabetic foot were found to have diabetic mellitus less than 10 years with minimum and maximum duration of 1 and 46 years respectively with median of 10 years. 71(69.6%) presented at KCMC Hospital with diabetic foot lesions of between 1- 5 month and only 27(26.5%) come to hospital with below 1 month duration of diabetic foot lesions, 70 (68.6%) had no associated co-morbid conditions 29 (28.4%) were known to have hypertension. By Wager wound classification grade 3 and grade 4 patients were equally found to be 26(25.5%) respectively followed by grade2 with 25 (24.5%) and the least grades were grade5 and grade1 with 15(14.7%) and 10(9.8%) respectively. On the outcome of DFU, 42(41.2%) were healed with debridement or sloughectomy, 36(35.3%) and 14(13.7%) of patients underwent minor amputation and major amputation respectively while 7 (6.9%) had unhealed wounds and 3(2.9%) died.
Conclusion. Diabetic foot ulceration constitutes a major source of amputation and death among patients with diabetes mellitus at Kilimanjaro Christian Medical Centre as most of patient present at the hospital while the ulceration has already reached the deeper structure (Wagner’s grade> III). A multidisciplinary team approach targeting at good glycemic control, education on foot care and appropriate foot wear, control of infection and early surgical intervention is required in order to reduce the amputation rate and death associated with DFUs. |
|