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International Journal of Medical Research & Health Sciences
Year : 2015, Volume : 4, Issue : 2
First page : ( 258) Last page : ( 264)
Online ISSN : 2319-5886.
Article DOI : 10.5958/2319-5886.2015.00048.X

The influence of peripheral neuropathy and peripheral vascular disease in the outcome of diabetic foot management – a prospective study

Prakash S Sundar1,*,  Krishnakumar2, Prabha Chandra3

1Assistant Professor, Department of General Surgery, Meenakshi Medical College and Research Institute, Kanchipuram

2Final year General Surgery PG, Department of General Surgery, Meenakshi Medical College and Research Institute, Kanchipuram

3Final year PG, Department of Physiology, Meenakshi Medical College and Research Institute, Kanchipuram

*Corresponding author email: drssp1967@gmail.com

Online published on 24 April, 2015.

Abstract

Objective

Peripheral neuropathy and Peripheral Vascular Disease are the risk factors for the development of diabetic foot. The aim of this study was to evaluate differences and predictors of outcome parameters in patients with diabetic foot by stratifying these subjects according to the severity of these risk factors.

Materials and Methods

This is a prospective study conducted in 70 patients in the age group of 30–90 years diagnosed as Type II Diabetes with foot ulcers. After detailed clinical examination the following tests were conducted in all the patients: Complete blood count (CBC), Haemoglobin (Hb), Random Blood Sugar (RBS), Erythrocyte Sedimentation rate (ESR), Chest X-ray(CXR), Electrocardiography (ECG), foot X-ray, pus culture, Neuropathy testing by Semmes Weinstein Monofilament Test and Vibration Perception Threshold and Peripheral vascularity assessment by Duplex Doppler. Then grading of the ulcers was done using Wagner's Grade. The outcome of the patients was assessed by recording the healing time, mode of surgery and amputation rates of the patients.

Results

A total of 70 patients with diabetic foot were consecutively included into the study (65.7% male, age (31% in 51–60 years), mean diabetes duration (5.2 years), Ulcer Grade (37% in Grade IV), Foot lesions (45.7% in toe), Blood sugar levels (64% in 300–400 mg/dl), Neuropathy (84%), Peripheral vascular disease (67%), major amputation (7%) and mortality (1.4%).

Conclusion

All diabetic patients should undergo testing for neuropathy and peripheral vascular disease apart from doing other tests.

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Keywords

Diabetic foot, ulcers, neuropathy, peripheral vascular disease.

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