DIABETIC FOOT PROBLEMS

Abstract

This study included 70 diabetic patients with ischemia. These patients were divided into 2 groups depending on the line of management used. Group I included 50 patients \\"ho had reconstructable vessels and who received different forms of arterial reconstructive procedures (aortobifemoral, axillofemoral, femoropopliteal and femorodistal bypasses), and group 2 included 20 patients who did not receive reconstructive operations but received either conservative management or pnmary major amputation. Arteriography was done in the majority of patients and Duplex scan in all patients. All patients had diabetic foot infections and almost all of them had neuropathy.

The results of treatment were as follows :

Group I : There was no postoperative mortality. Major morbidity occurred in 18% of cases (early graft occlusion, reactionary hemorrhage and acute renal failure). The overall bypass patency rate was 70% after 6 months and 58% after one year. Major amputation was required in 2 cases. One patient died during the follow-up perio¢.

Group 2 : Seven patients received major amputations from the start. Conservative management was successful in 6 patients and 7 more patients needed major amputations. Mortality after l year in group 2 patients was 50%.