EVALUATION AND MANAGEMENT OF DIABETIC FOOT ACCORDING TO WAGNER'S CLASSIFICATION A STUDY OF 100 CASES

Authors

  • Rooh -Ul- Muqim
  • Samson Griffin
  • Mukhtar Ahmed

Abstract

Background: Wagner's classification is the most widely utilized grading system for lesions of the diabetic foot. The aim of the study was to evaluate and manage the different lesions of diabetic foot according to Wagner classification. This will help to describe the lesions we treat study and compare outcomes and also identify measures to decrease morbidity and mortality due to diabetic foot disease. Methods: the study was conducted in surgical c unit of Khyber Teaching Hospital, Peshawar from July 2002 to June 2003. 100 patients with diabetic foot disease were included in the study. Detailed history, clinical findings and investigations were recorded. Lesions were graded according to wagner classification and appropriate medical and surgical treatment carried out. Results: diabetic foot disease formed 1.04% of total admissions and 0.23% of OPD patients. 62 (62%) were males and 38 were females. Common age group was 40 - 60 years, 6 patients had grade 0, 14 grade 1, 25 with grade 2, 30 with grade 4 and 4 with grade 5 lesions. 17 patients were managed conservatively with antibiotics alone, 33 had incision drainage and debridement while 48 needed amputation of different types. Staphylococcus aureus was the commonest organism isolated. Conclusion: majority of the diabetic foot lesions were in grade 2 to 5. Lesser  grade lesions responded well to conservative treatment with antibiotics and surgical debridement while those with higher grades needed amputations. Effective glycemic control, timely hospital admissions, approximate surgical / medical treatment along with patient education in foot care can decrease morbidity and mortality due to diabetic foot disease.Key words: Diabetes mellitus, Complications, Diabetic foot disease, Wagner's classification.

References

Griffiths GD. Diabetic foot disease. In Cuschieri SA, Essential Surgical Practice, 4th edition 2002 Arnold. 785-94.

Jawaid SA, Jafary HM. Training of nurses in diabetic care. (editorial) Pak J Med Sci 2003;19(2):67-69.

Green, Melissa F, Aliabadi, Zarintaj, Green, Bryan T. Diabetic foot: evaluation and management. South Med J 2002;95(1):95-101.

Zafar A. Management of diabetic foot-Two years experience. J Ayub Med Coll Abbottabad 2001;13 (1):14-6.

Brodsky JW. Staging and classification of foot lesions in diabetic patients. In Levin and O'Neals; The Diabetic foot, 6th edition. Mosby, Inc. 2001; 273-75.

Yonem A, Cakir B, Guler S, Azal OO, Corakei A. Effects of granulocyte-colony Stimulating factor in the treatment of diabetic foot infection. Diabetes Obes Metab 2001;3(5):332-7.

Andrew JM, Boulton, VileiKyte L. Diabetic foot problems and their management around the world. In Levin and O'Neals The diabetic Foot 6th edition. Mosby, Inc. 2001; 266.

Synder RJ, Cohen MM, Sun C, LivingstonJ. Osteomyelitis in the diabetic patient: diagnosis and treatment. Part 2: Medical, Surgical, and Alternative treatments. Ostomy Womd Manage 2001;47(3):24-30, 32-41; quiz 42-3.

Blume, Peter A, ; Single-Stage surgical treatment of non-infected diabetic foot ulcers. Plast Reconstr Surg 2002; 109 (2): 601-9.

Landau Z, Schattner A. Topical hyperbaric oxygen and low energy laser therapy for chronic diabetic foot ulcers resistant to conventional treatment. Yale J Biol Med 2001;74 (2): 95-100.

Deery HG 2nd; Sangeorzan JA. Saving the diabetic foot with special reference to the patients with chronic renal failure. Infect Dis Clin North Am 2001;15(3): 953-81.

O'Meara SO, Cullum N, Majid M, Sheldon T. Systematic reviews of wound care management: (4) diabetic foot ulceration. Health Technol Assess 2000;4 (21):1-237.

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How to Cite

Muqim, R. .-U.-., Griffin, S., & Ahmed, M. (2003). EVALUATION AND MANAGEMENT OF DIABETIC FOOT ACCORDING TO WAGNER’S CLASSIFICATION A STUDY OF 100 CASES. Journal of Ayub Medical College Abbottabad, 15(3). Retrieved from https://www.jamc.ayubmed.edu.pk/jamc/index.php/jamc/article/view/3976

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