Dr. P. Nellaiappar, Dr. A. P. Selvam, Sonia Sims, Thaddeus Alfonso


Background: Diabetic foot ulcer is a major complication in patients with diabetes mellitus and it calls for a surgical
intervention. Surgical management still remains a challenge.
Methods: Study was conducted at the Hand and Reconstructive Microsurgery Department in a Tertiary Care Hospital, Chennai. We used a
proforma for data collection and SPSS version 20 for analysis.
Results: Among 118 DFU patients with type 2 DM, 72% male and 28% female with a mean age of 55.4 years. Ischemic ulcer was the common
type and forefoot was commonly affected. Split skin grafting was done for a majority followed by debridement; many adhered to treatment,
diet and physical exercise; and 89% got their DFU healed in one-year follow-up.
Conclusion: Early and appropriate surgical intervention and management of patients with DFU would result in reduced morbidity and
mortality, and better quality of life.


Diabetic foot Ulcer, Type 2 Diabetes, Surgical Management, Treatment Outcome

Full Text:



Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Part 1: Diagnosis and Classification of Diabetes Mellitus (WHO/NCD/NCS/99.2). Geneva: World Health Organization; 1999.

Abbott CA, Carrington AL, Ashe H, Bath S, Every LC, Griffiths J, et al. The North-West diabetes foot care study: incidence of and risk factors for new diabetic foot ulceration in a community-based patient cohort. Diabet Med. 2002;19:377-84.

Centers for disease control and prevention lower extremity disease among persons aged ≥40 years with and without diabetes-United States, 1999-2002. MMWR Morb Mortal Wkly Rep. 2005;54:1158-60.

Robert S, Yoram R, Micha R. Diabetic Foot Ulcers: Principles of Assessment and Treatment. IMAJ. 2001;3:59-62.

International Working Group on the Diabetic Foot. Epidemiology of diabetic foot infections in a population-based cohort. Paper presented at: International Consensus on the Diabetic Foot. Noordwijkerhout, Netherlands: 2003.

Shahbazian H, Yazdanpanah L, Latifi SM. Risk assessment of patients with diabetes for foot ulcers according to risk classification consensus of International Working Group on Diabetic Foot (IWGDF) Pak J Med Sci. 2013;29:730–734. [PMC free article][PubMed]

Aalaa M, Malazy OT, Sanjari M, Peimani M, Mohajeri-Tehrani M. Nurses’ role in diabetic foot prevention and care; a review. J Diabetes Metab Disord. 2012;11:24. [PMC free article][PubMed]

Iraj B, Khorvash F, Ebneshahidi A, Askari G. Prevention of diabetic foot ulcer. Int J Prev Med. 2013;4:373–376. [PMC free article] [PubMed]

Fard AS, Esmaelzadeh M, Larijani B. Assessment and treatment of diabetic foot ulcer. Int J Clin Pract. 2007;61:1931–1938. [PubMed]

Snyder RJ, Hanft JR. Diabetic foot ulcers--effects on QOL, costs, and mortality and the role of standard wound care and advanced-care therapies. Ostomy Wound Manage. 2009;55:28–38. [PubMed]

Lavery LA, Armstrong DG, Wunderlich RP, Tredwell J, Boulton AJ. Diabetic foot syndrome: evaluating the prevalence and incidence of foot pathology in Mexican Americans and non-Hispanic whites from a diabetes disease management cohort. Diabetes Care 2003; 26: 1435-8.

Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA 2005; 293: 217-28.

Palumbo PJ, Melton LJ, III. Peripheral vascular disease and diabetes. In: Diabetes in America, Harris MI, Hamman RF (eds). Washington, DC: US Government Printing Office, 1985,; 1–21.

Reiber GE. The epidemiology of diabetic foot problems. Diabet Med 1996; 13: S6–S11.

US Dept of Health EaW. Report of the National Commission on Diabetes. Washington, DC: Government Printing Office, 1976.

Armstrong DG, Lavery LA, Quebedeaux TL, Walker SC. Surgical morbidity and the risk of amputation due to infected puncture wounds in diabetic versus nondiabetic adults. South Med J 1997; 90: 384-9.

Moxey PW, Gogalniceanu P, Hinchliffe RJ, Loftus IM, Jones KJ, Thompson MM, etal. Lower extremity amputations: a review of global variability in incidence. Diabetic Med. 2011;28(10):1144-53.

Katsilambros N, Dounis E, Makrilakis K, Tentolouris N, Tsapogas P. Atlas of the diabetic foot. Oxford: Wiley-Blackwell; 2010.

Nyamu PN, Otieno CF, Amayo EO, Mcligeyo SO. Risk factors and prevalence of diabetic foot ulcers at Kenyatta National Hospital, Nairobi. East Af Med J. 2003;80(1):36-43.

Abbas ZG, Lutale JK, Morbach S, Archibald LK. Clinical outcome of diabetes patients hospitalized with foot ulcers, Dar es Salaam, Tanzania. Diabetic Med. 2002;19(7):575-9.

Abbas ZG, Archibald LK. Challenges for management of the diabetic foot in Africa: doing more with less. Int Wound J. 2007;4(4):305-13.

Doumi A. Diabetic septic foot in El Obeid, Western Sudan. Sudan J Med Sci. 2007;2(2):119-21.

Morbach S, Lutale JK, Viswanathan V, Mollenberg J, Ochs HR, Rajashekar S, et al. Regional differences in risk factors and clinical presentation of diabetic foot lesions. Diabetic Med. 2004;21(1):91-5.

Viswanathan V. The diabetic foot: perspectives from Chennai, South Africa. Int J Low Extrem Wounds. 2007;6:34-6.

Sade R, Jatothu D, Taruni, Sade K, Pyadala N. Management of diabetic foot ulcers in a teaching hospital. Int Surg J 2017;4:3088-91.

Akanji AO, Adetuyidi A. The pattern of foot lesions in Nigerian diabetic patients. West Afr J Med. 1990;9:1-5.

Mahboob G, Ali R, Imran S. Frequency of lower extremity amputation in diabetics with reference to glycemic control and Wagner's grade. J Coll Physician. Surg Pak. 2006;16(2):124-8.

Al-Ebous AD, Hiasat B, Sarayrah M. Management of diabetic foot in a Jordanian hospital. East Mediterranean Health J. 2005;11(3):490-3.

Sano D, Tieno H, Drabo Y, Sanou A. Management of the diabetic foot, apropos of 42 cases at the Ougadougou University Hospital Center. Dakar Med J. 1998;43:110-3.

Orji FA, Nwachukwu NC, Udora EC. Bacteriological evaluation of diabetic ulcers in Nigeria. Afr J Diabetes Med. 2009:19-23.

Abdulrazak A, Ibrahim Bitar Z, Ayesh A, Mobasher LA. Bacteriology study of diabetic foot infection. J Diab Compl. 2008;19:138-41.

Alavi SM, Khosravi AD, Sarami A, Dashtebozorg A, Montazeri EA. Bacteriologic study of diabetic foot ulcer. Pak J Med Sci. 2007;23:681-4.

Singh N, Armstrong DG, Lipsky BA. Preventing Foot Ulcers in Patients with Diabetes. JAMA.2005;293(2):217–228. doi:10.1001/jama.293.2.217.


  • There are currently no refbacks.