Assessment of limb salvage in peripheral arterial disease in diabetic foot ulcer: A prospective study
Journal Title: International Archives of Integrated Medicine - Year 2017, Vol 4, Issue 6
Abstract
Introduction: The association of peripheral arterial disease in diabetic foot ulcer is an emerging risk factor for accelerated limb amputations. Presence of ischemia delays the wound healing increasing the likelihood of limb loss. Most amputations can be prevented and limbs salvaged through a multimodal treatment of infection control, wound debridement and revascularization procedures. Materials and methods: This was a prospective study which involved type 2 diabetic patients with isolated foot ulcer (DFU). WIFI- G score was incorporated in the wound assessment. A total of 100 patients were evaluated in this study. Once diagnosed with PAD, patients underwent vascular surgery consultation and were put on appropriate treatment. The patients were followed up for a period of 3 months from definitive procedure to assess the ulcer healing and limb salvage. Results: There was significant association of PAD with high WIFI index. Osteomyelitis was strongly associated with PAD (59%, p=0.003). PAD was associated with higher amputation rates (53.8%, p=0.003). Of minor lower limb amputations, only 47% were associated with PAD whereas of all major amputations, 87% were associated with PAD (p= 0.002). Also higher amputation rates correlated with a high WIFI score (p<0.0001). Conclusion: Revascularization limits the level of amputation and facilitates healing of stump. Major amputations were reduced to half with revascularization. Revascularization if indicated should be done at the earliest onset to attain the benefit of limb salvage.
Authors and Affiliations
G. Thulasikumar, Vijayasarathy S.
Keywords
Related Articles
- EP ID EP408732
- DOI -
- Views 119
- Downloads 0
Effectiveness of Mobilization with Exercise V/S Mulligan Internal Rotation MWM with Stretching in Patient with Glenohumeral Internal Rotation Deficit
Background: The glenohumeral joint consists of dynamic and static stabilizer, which works, in concert to allow for stability and mobility through a large arc of motion, in recent years there has been significant focus on...
Gallbladder wall thickening at ultrasonography - A review
The aim of the present review was providing help for the assessment of the correct interpretation of gallbladder wall thickening and differential diagnosis at ultrasonography. Gallbladder wall thickening is a frequent so...
Accuracy of fine needle aspiration cytology with histopathology of thyroid lesions - 1.5 years study at Government ENT hospital, Hyderabad, Telangana
Background: Swellings of thyroid gland are common in most parts of the world, including countries like India where iodine deficiency is endemic. Its prevalence ranges from 4% to 10% in the general adult population and fr...
Evaluation of validity of cone beam CT (CBCT) measurements compared to direct method on human dry mandibles
Introduction: Cone beam computed tomography (CBCT) has its wide range of uses in dentistry most commonly as an aid in preoperative planning of dental implant treatment. However, in order to determine the best application...
Incidence, clinical profile and outcome of poisoning patients in a tertiary care hospital, Chennai
Poisoning is one of the commonest health problems in patients who present to Emergency Department, causing significant morbidity and mortality in them. The present study is aimed at assessing the incidence, clinical prof...