Study of factors affecting wound healing following severe foot infections in patients with diabetes mellitus

Author: 
Narain Nikhil., Ansari Md Abu Masud., Chawla A S., Bhatnagar D., Srinivas S., Agarwal Yatish and Biswas Krishna

Aims and Objectives: This prospective study attempted to identify the risk factors governing the healing of infected diabetic foot and segregate individuals who may benefit with an early surgical intervention.
Methods: The study was an observational study on diabetic patients admitted to Safdarjang Hospital with severe foot infections. Patients were assessed for Peripheral arterial disease (PAD), Peripheral neuropathy (PN), wound severity by International consensus of Diabetic Foot (ICDF) classification, Glycosylated Haemoglobin values and malnutrition.
The patients were managed with insulin, IV antibiotics and wound debridement.
Subjects were followed up for 6 weeks and data was recorded in terms of wound healing or not healing.
Results: Our study was conducted over a period of 2 years, 6 months on 58 patients.
26 patients belonged to grade 2 and 3 each and 6 were characterized as ICDF grade 4.
In our study 20 patients had a satisfactory glycaemic control, 42 were malnourished, 39 had peripheral neuropathy and 24 had vasculopathy.
Out of 23 cases that did not heal, 20 were high grade ICDF with a p value of .000., 5(21.7%) had a satisfactory glycaemic control (p value .098.), 22(95.7%) were malnourished (p value 0.001), 20(87%) had peripheral neuropathy (p value 0.01.), Vasculopathy was present in 17(73.9%) (p value .000.)
Out of 35 patients who healed,15 had a satisfactory glycaemic control ( p value .098.), 20 were malnourished, 16 had peripheral neuropathy (p value 0.01.), Vasculopathy was present in 7 (p value. 000.)
Conclusion: Vasculopathy, peripheral neuropathy, malnutrition and poor ICDF grade were significant risk factors for non-healing of wound. We did not find a significant correlation between satisfactory glycaemic control and wound outcome.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2019.17075.3183
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