Bagadeesh, P (2020) A Study on Outcome of Diabetic Foot Ulcers based on Wound Severity Score. Masters thesis, Madras Medical College, Chennai.
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Abstract
AIM: To predict the outcome of the diabetic foot ulcers based on clinical scoring system – Diabetic ulcer severity score (DUSS) OBJECTIVES: To study the progress of ulcer healing in diabetic patients. To study the different techniques of surgical interventions needed in the management of diabetic foot ulcers. To study the incidence of amputations in patients with diabetic foot ulcers. MATERIALS AND METHODS: 100 Diabetic patients with diabetic foot ulcer attending general surgery outpatient clinic or admitted in Madras medical college and hospital are studied. It is a prospective study with sample size of 100 conducted from January 2018 to June 2019. Scoring was based on four clinical parameters, palpable pedal pulse, probing to bone, ulcer site, ulcer number from0 to 4. RESULTS: In this study the most commonly affected population were male patients with habits of smoking and alcohol. Based on occupation daily wages are commonly affected. Scoring was developed with the four clinical parameters. When the DUSS score was compared with primary healing 91.3% of the patients with score 0, 82.6% of the patients with score, 70% of the patients with score 2, 20% of the patients with score 3 and 0% of the patients with score 4, the wound underwent primary healing after wound dressing regularly. By comparing the DUSS score with split thickness skin grafting, none of the patients with score 0, 8.7% of the patients with score 1, 10% of the patients with score 2, 30% of the patients with score 3 and 28.6% of the patients with score 4 underwent split thickness and skin grafting. On comparing minor amputation with DUSS scoring, 4.3% of the patients with score 0, 8.7% of the patients with score 1, 10% of the patients with score 2, 30% of the patients with score 3 and 28.6% of the patients with score 4, underwent minor amputation for diabetic foot ulcer. On comparing the DUSS score with major amputation, none of the patients with score 0 and 1, 10% of the patients with score 2, 20% of the patients with score 3 and 42.9% of the patients with score 4 underwent major amputation. In our study none of the patients with score 0 and 1 underwent major amputation. Major amputation increases in the patients with DUSS score of 3 and 4. CONCLUSION: Diabetic ulcer severity scoring (DUSS) system provides an easy diagnostic tool for predicting probability of healing or amputation by combining four clinical assessable wound-based parameters. Study groups can be stratified depending on severity of ulcers and thus can help provide a simple, streamlined approach in clinical setting without need of any advanced investigative tool, but it does not alter the procedure of wound management. In this study patients with lower DUSS scores did not require any major amputation, whereas those with higher scores required major amputation as a part of their management. The results of this study corroborate with similar studies performed with DUSS scores in other centres. Therefore, DUSS score is a simple and easily reproducible that can be used in patients with diabetic foot ulcers in routine surgical practice.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711003 |
| Uncontrolled Keywords: | Diabetic Foot Ulcers, Wound Severity Score. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 09 Feb 2021 00:11 |
| Last Modified: | 09 Feb 2021 00:11 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13927 |
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