Arul, P (2020) Study of Microbiological Spectra Associated with Sinbad Grades of Diabetic Foot Ulcer and Its Clinical Relevance. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
INTRODUCTION: Infected foot ulcer is a common cause of morbidity in diabetic patients, ultimately leading to dreaded complications like gangrene and amputations. Life time risk to a person with diabetes for developing a foot ulcer could be as high as 25%. Infection is most often a consequence of foot ulceration, which typically follows trauma to a neuropathic foot. The alarming fact is that India has more people with diabetes than any other country and the incidence of foot problems and amputations remains very high, accounting for upto 20% of diabetes – related hospital admissions. In India, the choice of empirical antimicrobials is extrapolated from data available from western countries, which may or may not be appropriate for Indian patients. While the University of Texas system & Wagner's grading has been widely adopted, we are using SINBAD classification which is widely accepted across four major countries. This classification is based on site, infection, neuropathy, vascularity, area and depth of the foot ulcer in diabetic ulcers. OBJECTIVES & METHODOLOGY: The objectives are to study the most common grading in SINBAD classification in our locality and to study the common organisms in most of the diabetic ulcer foot patients in our locality and to decide about the appropriate antibiotic for starting empirical therapy with available evidence depending on SINBAD grades. A hospital based cross sectional study is done in patients with diabetic plantar foot ulcer in surgery wards and out patients of Kilpauk Government Medical College for a period of April 2019 to Sep 2019. Sample size is 100. Specimens (pus, wound exudates) for microbiological studies were obtained from the ulcer region. These specimens were immediately transported to the microbiology laboratory for identification of the micro organisms, and culture & sensitivity. CONCLUSION: Most common age group is 50-60 yrs with male to female ratio of 1.8:1.99% of patients are Type2 diabetics with median duration of 10 yrs. Median duration of ulcer is 20 days commonly of spontaneous origin involving mid/hind foot. Neuropathy & vasculopathy was seen in 24% and 38% of patients. Most of them had active infection involving deeper tissues. Grade 4 ulcers are more common. Mono-microbial cultures are predominant with most common being Staph. aureus followed by E.coli. Most common sensitive antibiotic is piperacillin tazobactem followed by imipenam. Hence, these antibiotics can be used for empirical therapy before getting culture sensitivity reports.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711152 |
| Uncontrolled Keywords: | SINBAD grades, diabetic foot ulcer, Staph. aureus, piperacillin tazobactem. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Feb 2021 15:10 |
| Last Modified: | 10 Feb 2021 15:10 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13985 |
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