Diabetic Foot Ulcers: Epidemiology, Management Modalities and Outcome at Benue State University Teaching Hospital Makurdi

Abstract

Aim: To determine the epidemiology of diabetic foot ulcers (DFU), types, and the risk factors associated with their development at Benue State University Teaching Hospital, Makurdi Nigeria. To assess outcome of various modalities of treatment and mortality. Study Design: This was a four year retrospective study of consecutive patients admitted at Benue State University Teaching Hospital Makurdi with diabetic foot ulcers. Data was collected using a proforma form in November and December, 2016. Methodology: Data collected from 46 patients files included socio-demographic parameters of age, sex, type of diabetes mellitus, Meggitt-Wagner’s grading of the ulcers, fasting blood glucose on the second day of admission, glycaemic control and type of drugs used, duration of ulcers before presentation to hospital, types of ulcers and risk factors for their development, length of hospital stay, surgical modalities of treatment and ulcer defect cover, patients who had amputations and mortality. Results: Forty six patients files showed that patients with DFU were males in 43.5% of cases and females in 56.5%, with a male: female ratio of 1:1.3. The age range of patients was 25 – 75 years with mean age of 51.6 (± 10.4) years. The commonest aetiology for diabetic foot ulceration was peripheral neuropathy seen in 47.8% of cases. Most patients presented with Meggitt-Wagner grade IV ulcers. Vast majority of patients (91.3%) had type 2 diabetes. Honey was the main dressing agent used for the ulcers. Sepsis was the major complication seen. Twelve patients underwent amputations at various levels.  Outcome of treatment was healed ulcers in 34.8% of patients, amputations in 26.1% and mortality in 23.9%. Conclusion: The study showed peripheral neuropathy as the commonest aetiology of diabetic foot ulceration. Health education on proper care of the foot and compliance with anti-diabetic drugs will help in preventing diabetic foot ulceration with its consequences.