Frequency and extent of Foot Lesion and the Susceptibility Pattern of Infective Organisms in Diabetic Foot

Abstract

Objective: To determine frequency and extent of foot lesion and the susceptibility pattern of infective organisms in Diabetic foot. Design: (Descriptive) cross sectional study. Place and duration of study: Surgical Unit –II Holy Family Hospital, Rawalpindi completed in 4 months (5 Feb.2008 to 5 June, 2008). Patients and methods: A total of 50 consecutive patients with diabetic foot lesions were assessed for angiopathy, neuropathy and extent of foot lesion. Necessary investigations including x-ray foot, pus for culture & sensitivity and fungal scraping were carried out. Results: 40% of total patients were insulin dependent diabetics (IDDM) out of which 80% were on irregular treatment. 52% of total patients were non insulin dependent (NIDDM) out of which 73% were on irregular treatment and 8% of total patients were getting no treatment. Most of the infection were due to staphylococcus aureus (22%), pseudomonas (18%) Proteus (16%) E.Coli (12%) Streptococci(12%). Angiopathy was present in 62% patients and partial or complete sensory loss was present in 74% patients. 54% patients had Osteomyelitis. 61% patients had partial or complete sensory loss in Grade I, II, III and in (Grade IV&V), 100% patients had partial or complete sensory loss.  All the patients in Grade IV&V had random blood sugar values more than 200md/dl, showing poor glycaemic control. Conclusion: Diabetic foot lesions are more common in older age group, mostly in males and present in fairly advanced grades (Grade III, IV&V). Main contributing factors are sensory neuropathy, angiopathy, poor glycaemic control. Most common infecting organisms are staphylococci and pseudomonas.