Madhuri Jain, Ranjeet Kamble, Vineet Kumar
The study nearly 415 million people globally have diabetes, with 75 % living in low and middle income countries. In India, about 70 million people have diabetes and the number is projected to rise to 125 million by 2040. The aim of this study is to analyses various factors affecting wound healing in diabetic foot patients like glycaemic control (HbA1c), nutritional status and peripheral vascular disease. We also evaluated the disease load, the morbidity associated with diabetic foot in the form of amputations and also mortality. This study also examined the traditional and novel therapies like negative pressure wound therapy, hyperbaric oxygen therapy, various dressings to expedite wound healing. Our study was performed at a tertiary care hospital where 200 inpatients having infected diabetic foot were studied. The outcomes of traditional surgical techniques over recent modalities were studied. We found that apart from local factors, systemic factors like malnutrition, anaemia and presence of long - standing uncontrolled diabetes severely impacted prognosis. Amongst all the risk factors peripheral vascular disease was associated with the highest mortality. Significant number of patients benefitted with adjuvant therapy amongst which negative pressure wound therapy had significantly better outcomes, others like hyperbaric oxygen therapy and cadaveric skin graft were comparable.