Direct Inflicting Causes of Diabetic Foot Ulcer & the Initial Action of Patient & Health Provider

Siddig Ad-DawAlshareef and Mohamed Elmakki Ahmed

Department of Surgery, Jabir Abu Eliz Diabetic Centre, Khartoum, Sudan
Department of Surgery, University of Khartoum, Sudan

^*Correspondance to: Mohamed El Makki Ahmed 

 PDF  Full Text DOI: 10.25107/2474-1647.1432

Abstract

Background: The role of neuropathy and angiopathy in the causation of the diabetic foot are well established. The purpose of this study is to investigate the effects of direct precipitating causes of diabetic foot ulcer and the initial action of patient and primary health provider on outcome of DFU.Patients and
Method: This prospective study was conducted in Jabir Abu Eliz Diabetic Centre (JADC), Khartoum, Sudan. Recorded data included patient’s demographics, DFU direct inflicting cause, initial behaviour of the patient, information related to the 1st health provider, and outcomes.Results: A total of 134 patients who had diabetic foot ulcer (DFU) were included. The mean age of the studied patients was 56.78 ± SD 10.2 years with a male to female ratio (4.6: 1). The mean duration of DFU was 36 ± SD 97 days. Neuropathy and angiopathy were reported in 76.9% and 25.3% of patients respectively. Grade of infection was significantly associated with foot self-examination (p=0.006), and duration of DFU (p=0.032). The common direct causes of foot ulcer were blister (28.4%), penetrating injuries / sharp injuries (23.1%), and unidentified causes (22.4%). Outcome of ulcer was significantly associated with direct precipitating causes of DFU (p=0.033), level of 1st health provider (p=0.000), and the action of 1st health provider (p=0.007). Major lower limb amputation and chronic ulcers were encountered in ulcers precipitated with ill-fitting shoes/socks or penetrating / sharp injuries, seen by physicians, and treated with antibiotics after sever sepsis.Conclusion: The most direct precipitating causes of DFU are avoidable. Presentation of DFU is affected with patient behaviour and delay in presentation to JADC. We recommend developing a community intervention programme to increase the awareness among diabetic patients and encourage earlier multidisciplinary team assessment to reduce disparities and improve foot outcomes in patients with diabetes.

Keywords

Diabetic foot ulcer; Inflicting causes; Major lower limb amputation

Cite the article

Ad-DawAlshareef S, Ahmed ME. Direct Inflicting Causes of Diabetic Foot Ulcer & the Initial Action of Patient & Health Provider. Clin Surg. 2017; 2: 1432.