Diabetic Foot: its grades and mode of presentation at a tertiary care hospital of Peshawar, Khyber Pakhtunkhwa, Pakistan
Keywords:Diabetes Mellitus, Diabetic Foot, Peripheral Vascular Diseases, Neuropathy
Introduction: Diabetic foot is defined as the foot of diabetic patients with ulceration, infection, and/or destruction of the deep tissues, associated with neurological abnormalities and various degrees of peripheral vascular disease in the lower limb. Foot ulcers are the principal cause of severe complications and hospitalization among patients with diabetes, substantially increasing the costs of this disease.
Objectives: To describe the presentation, distribute the diabetic foot lesions according to Wagner’s classification, and determine the outcome of diabetic foot ulceration in a tertiary care hospital of Peshawar, Pakistan.
Materials & Methods: This study was conducted in the Surgery department of Rehman Medical Institute Peshawar. Thirty nine (39) patients with diabetic foot disease presenting from Jan 2018 to Dec 2019 were included in the study. The patients were evaluated and managed by classifying their disease according to Wagner’s classification for diabetic foot disease. Statistical analysis was done by using SPSS version 26 for descriptive statistics.
Results: The most common age of presentation with diabetic foot lesion was between 41-70 years; out of 39 patients, 28 (71.8%) were males and 11 (28.2%) were females. Their mode of presentation was as follows- 22 cases (56.4%) with Ulcer, 9 cases (23.1%) with Cellulitis, 7 cases (17.9%) with Gangrene, and 1 case (2.6%) with Abscess. The most common grade of presentation were grades 3 and 4 Wagner’s lesion followed by Grade 1, and Grade 2. Debridement was the most common treatment modality (56.2%), followed by Amputation (41%).
Conclusion: Foot ulceration in diabetic patients is a resource-consuming, disabling morbidity that often is the first step towards lower extremity amputation. Diabetic foot lesions can be easily graded according to the Wagner classification and helps in correlating appropriate treatment to the grade of the lesion for a better outcome.