Risk assessment of amputation in patients with diabetic foot

Abstract

The prevalence of diabetes has increased dramatically over the past decade, especially in developing countries, reaching pandemic proportions. Although has been the most important factor influencing the prevalence of type 2 diabetes, the prevalence of type 2 diabetes is on the increase among younger adults. The subsequent rate of increase with age is variable, which is more evident in societies where the general prevalence of the disease is higher. Based on clinical and statistical data obtained from the patients who were admitted to The First and Second Surgery Wards in the Sibiu County Emergency University Clinical Hospital (Sibiu, Romania) and the Proctoven Clinic (Sibiu, Romania) between January 2018 and December 2020, the present study attempted to devise a risk score that can be applied for the benefit of patients. The ultimate aim was that this risk score may be eventually applied by diabetologists and surgeons to assess the risk of amputation in patients with diabetic foot lesions. An important part in the therapeutic management of diabetic foot injuries is the assessment of risk factors. Using this risk score system devised, the risk factors that were found to exert influence in aggravating diabetic foot injuries are smoking, obesity, dyslipidaemia, unbalanced diabetes mellitus (glycated haemoglobin ≥7.5%), duration of diabetes >5 years, hepatic steatosis and the co-existence of various heart diseases. To conclude, all these risk factors aforementioned can decrease the effectiveness of treatment and can have a significant impact on the quality of life, if they are not well known.

Tratamiento clínico – quirúrgico actualizado del pie diabético revisión bibliográfica

“…En el estudio de Tanasescu et al (42) se ha evaluado el efecto del tratamiento quirúrgico por lesiones del pie diabético mediante diversos métodos, tras el análisis de las intervenciones, la amputación y el desbridamiento en conjunto representaron el 66% del total de procedimientos quirúrgicos en el pie diabético, siendo la amputación la intervención quirúrgica más común, cuyos pacientes presentaron comorbilidades como enfermedades cardíacas, seguida de obesidad y dislipidemia, los cuales se observaron https://doi.org/10.55204/scc.v2i2.e23 con mayor frecuencia en pacientes con HbA1c >7,5%, en aquellos con una duración de la diabetes >5 años y aquellos con dislipidemia, siendo más prevalente en el grupo etario de 60 -70 años. Los resultados del presente estudio han corroborado que el tratamiento de las úlceras del pie diabético es complejo e implica el uso de métodos convencionales como innovadores, como terapia con antibióticos, vendajes para heridas, terapia de presión negativa, desbridamiento del tejido necrótico, para prevenir amputación.…”

Examining the effect of polyurethane dressing containing silver particles on the rate of diabetic foot ulcer infection in hospitalized patients: A randomized control study

“…8 By causing many socioeconomic effects, this complication enhances the possibility of amputation in diabetic patients. 11 If the diabetic foot wound becomes infected, the conditions will become more difficult for the patient and the healing process will be very slow. 12 The intensity of the diabetic foot infection can be superficial or the infection might have involved the bone deeply.…”

“…These types of wounds are seen as serious and dangerous complications of diabetes since they worsen the patient's clinical condition and diminish their quality of life 8 . By causing many socioeconomic effects, this complication enhances the possibility of amputation in diabetic patients 11 . If the diabetic foot wound becomes infected, the conditions will become more difficult for the patient and the healing process will be very slow 12 …”