Evaluation and Management of Diabetic Foot: A Multicenter study conducted at Rawalpindi, Islamabad

Objectives: To evaluate and manage the different lesions of diabetic foot according to Wagner classification. Materials and Methods: Wagner’s classification is the most widely utilized grading system for lesions of diabetic foot disease. The aim of the study was to evaluate and manage the different lesions of diabetic foot according to Wagner classification. Study Design: Prospective study. Place and Duration of Study: The study carried out at Pakistan Institute of Medical Sciences, Islamabad, Federal Government Services Hospital, Islamabad and Benazir Bhutto Hospital, Rawalpindi. This study included 1053 patients with diabetic foot disease presenting from January 2008 to December 2010. Results: Males were more affected than females (1.12:1). The most common age group of patient with foot involvement was between 41-60 years. The mean duration of diabetes of study population was 11.4 years. The commonest grade was Grade IV which included 360 (34.1%) patients followed by Grade II which included 229 (21.74%) patients and Grade III which included 170 (16.14%) patients. The most common infecting organism isolated on cultures was staphylococcus aureus which was present in 223 (21.2%). 246 (23.36 %) patients were managed conservatively and surgical management was carried out in the rest of the 807 (76.64 %) patients. Amputation was performed in 369 (35.04 %) patients. Conclusions: Majority of the diabetic foot lesions were in grade II to V. 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, appropriate surgical / medical treatment along with patient education in foot care, can decrease morbidity and mortality due to diabetic foot disease.