Characteristics of foot ulcers in diabetic patients

Czech version

Authors: L. Štrbová ¹; B. Krahulec ¹; I. Waczulíková ²; Ľ. Gašpar ¹; E. Ambrózy ¹
Authors‘ workplace: II. interná klinika Lekárskej fakulty UK a FNsP, Nemocnica Staré Mesto, Bratislava, Slovenská republika, prednosta prof. MU Dr. Andrej Dukát, CSc. ¹; Oddeleni e bi omedicínskej fyziky Fakulty matematiky, fyziky a informatiky UK Bratislava, Slovenská republika, prednostka prof. RNDr. Libuša Šikurová, CSc. ²
Published in: Vnitř Lék 2009; 55(10): 918-924
Category: Original Contributions

Overview

Introducti on:
Di abetic fo ot syndrome is often presented as a skin lesi on in di abetics. The aim of o ur study was to analyse fo ot ulcerati ons in di abetics, together with ethi opatogenesis, locati on and grade of impairment. Methods: We analysed fo ot ulcerati ons in 124 di abetics who attended o utpati ent fo ot clinic, or were hospitalized in the peri od from 1996 to 2006. Basic ne uropathy screening examinati on was made with cotton wisp, pin‑prick, tuning fork, and monofilament. Beside the evalu ati on of the presence of pedal pulses, the ankle-brachi al pressure index was me asured. If the infecti on of fo ot ulcerati on was present, bacteri ology examinati ons was performed. Wagner and University of Texas classificati ons of fo ot ulcerati ons were appli ed, more over, locati on of ulcerati ons was analysed. Results: Ne uropathic ulcer was di agnosed in 46 pati ents of the total number of 124 (37%), ne uro ischemic in 76 pati ents (61%) and pure ischemic ulcer only in 2 pati ents (2%). Ne uropathy was present in 122 (98%) pati ents with di abetic fo ot, limb ischemi a in 78 pati ents (63%). Fifty fo ur per cent of fo ot ulcers were located on toes and 43% ulcers on plantar surface. Fo ot ulcer infecti on was detected in 72 pati ents (58%). We fo und 48 superfici al ulcers (38.7%) and 76 deep ulcers (61.3%). In di abetics witho ut fo ot ischemi a and infecti on 39% deep ulcers were present where as in the gro up with ischemi a and infecti on the proporti on amo unted to 80% (p < 0.05). Conclusi on: Di abetic fo ot syndrom was present more often in type- 2 di abetics with longer dise ase durati on, in those on insulin tre atment, in men of older age, further in the di abetics with pure glycemic control and/ or with chronic microvascular di abetic complicati ons.

Key words:
di abetic fo ot – ulcer locati on – clinical picture of fo ot ulcerati ons – risks of di abetic fo ot syndrome

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