Surgical septic complications of the diabetic foot – a single center experience

  • Ramona Dragomir "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
  • Ruxandra Stănculescu "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
  • Florin Bobirca Carol Davila university of Medicine and Pharmacy
  • Oana Toader "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania & “Alessandrescu – Rusescu” National Institute for Mother and Child Health, Bucharest, Romania
  • Călin Ionescu ”Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania & 5th Surgical Clinic, Cluj-Napoca Municipal Hospital, Cluj-Napoca, Romania
  • Anca Bobircă "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania & “Dr. Ion Cantacuzino” Clinical Hospital, Bucharest, Romania
Keywords: Diabetic foot, amputation, surgery, diabetes mellitus

Abstract

Abstract: Diabetic foot includes all the pathogenic changes that are caused by diabetes mellitus (DM): damage to the nerves, vessels, bones and soft tissue, causing changes in the biomechanics of the foot, severe infections and tissue damage. Diabetic foot has a higher risk of amputation compared to the risk of nephropathy or retinopathy caused by DM and is the most common cause of hospitalization of patients with DM. In the management of these patients, the most important things are a good glycemic control, lifestyle change and the choice of an appropriate medical and surgical treatment. We conducted a retrospective study on 299 patients with type 1 (DMT1) or 2 (DMT2) of DM associated with septic lesions in the lower limb, hospitalized in the General Surgery Department of the Clinical Hospital „Dr. Ion Cantacuzino” between January 1, 2020-December 31, 2021. A better glycemic control was found in patients receiving insulin (20.3% ) in contrast  to those on oral antidiabetics (16.3%). Vascular involvment was found in 90.6% of cases, followed by neuropathy (27.1%). 95.5% of patients treated with insulin had arteriopathy in their disease pathology, and those treated with oral antidiabetics were diagnosed with arteriopathy in 86.7% of cases. The main type of lesion was wet gangrene, in 59.9% of patients. Necrosis and ischaemic gangrene are found in 19.7% of cases and 16.7% respectively.

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Published
2022-05-28