Frequency of lower extremity amputations in patients with diabetics foot ulcers

Background: diabetes mellitus is one of the most common non-communicable diseases globally.it is one of the major contributors to ill health and mortality worldwide. diabetic foot ulceris a majorcomplication of diabetes mellitus,and major component of thediabetic foot.these complex chronic wounds not only lead to disability and impairment of quality of life,but are associated with high rates of hospitalization and non traumatic amputations. aim: to study the frequency of lower extremity amputations in diabetics,in order to identify risk groups that should be targeted for preventive treatment. methods: this observational study was conducted in the department of general surgery at nawaz sharif social security teaching hospital lahore,over a period of 3 years (july 2014 to july 2017).this study carried out in 200 patients of diabetic foot disease,who were distributed in to six grades of severity according to the wagner's classification. age,gender,duration of diabetes mellitus and the type of lower-extremity amputations were recorded. results: in the current study,200 patients including 148 males (74%) and 52 females (26%) with diabetic foot lesions were treated.majority of the patients were in the age group between 30-71 years (average age 55 years). 52% patients were on oral hypoglycemic agents,46% were using insulin,while 2% were not following any treatment. duration of diabetes was greater than 10 years in 62% of patients.majority of the patients presented in grade iii,iv and v (68%) of wagner's classification. all the patients were lacking health education and none of them was aware of proper foot care in diabetes. no patient in grade i underwent amputation,while 11(25%),27(58.69%) and 27(45%) underwent minor amputation in grades ii,iii and iv respectively.10 (21.7%),33 (55%) and all 30(100%) underwent major amputation in grade iii,iv and v respectively. conclusion: diabetic foot is a leading cause of lower extremity amputations.it is a huge economic burden on the patients associated with high morbidity and mortality.the frequency of minor and major amputation increases with the increasing grades of diabetic foot. most of the patients in our study presented with higher grades (iii,iv & v) of severity and underwent major amputations.