Ashwin Prem Solomon, P (2020) Prediction of amputation in diabetic foot ulcers using SVS WIfI scoring system. Masters thesis, Christian Medical College, Vellore.
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Abstract
BACKGROUND: Foot ulcers and their complications are an important cause of morbidity and mortality in patients with Diabetes. About 80% of patients undergoing non-traumatic lower limb amputations have Diabetes. In patients with diabetes, limb threat is part of a broad disease spectrum. Perfusion is only one determinant of outcome. Wound extent, infection also greatly impact the threat to a limb. WIfi scoring system has been validated in diabetic foot ulcers in the West. AIM OF THE STUDY: To predict the risk of amputation in diabetic foot ulcers using WIfI scoring system. OBJECTIVES: 1. To study the predictive role of WIfI staging system in diabetic foot ulcers undergoing amputation. 2. To study the association between individual components of WIfI staging system and outcome of diabetic foot ulcers 3. To study the association between glycemic control and outcome of diabetic foot ulcers. MATERIALS AND METHOD: The subjects were patients with diabetic foot ulcers presenting to General surgery, Vascular Surgery or Diabetic foot clinic in Christian Medical College, Vellore. WIfI scoring of the diabetic ulcer was done after obtaining informed consent from the patient at the time of presentation. Patients were followed up at 6 months and outcome was noted. RESULTS: A total of 163 patients were recruited in this study. 60 belonged to group 1 comprising of WIfI stages 1-3 and 103 belonged to group 2 comprising of WIfI stage 4. Among the 163 patients, 113(69.3%) patients underwent amputations (minor and major). 50(30.7%) of them had major amputations ( level proximal to the ankle). In patients with WIfI stage 4, 90.9% [93/103] underwent amputations within six months of recruitment. 45.6% of them underwent major amputation. Major amputation in group 1 patients [WIfI stages 1-3] was 5%. 70% who underwent major amputations had HbA1C values of > 6.4 mmol/L. CONCLUSIONS: WIfI scoring system was predictive of major amputations in patients with diabetic foot ulcers within six months of recruitment. Poor glycaemic control was associated with worse outcome.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711453 |
| Uncontrolled Keywords: | Prediction, amputation, diabetic foot ulcers, SVS WIfI scoring system. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 12 Feb 2021 16:40 |
| Last Modified: | 12 Feb 2021 16:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14064 |
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