Abstract:
Diabetes is the commonest cause of foot ulceration in developing countries leading to severe morbidity and
mortality. The main aim of this study was to assess anatomical distribution of diabetic foot lesions,
categorize it according to Wagner wound grading, find any association between smoking packs years and the
severity of the foot lesions. Also to assess the relationship between the bony deformities and anatomical
distribution of the ulcers. This was a cross sectional descriptive study conducted in a casualty surgical unit
in a tertiary care teaching hospital for a period of 4 months. 91 diabetic patients with a diabetes related foot
lesion were enrolled after simple randomization. Pretested interviewer administered questionnaire was used
to gather data. Variety of soft tissue and bony changes of diabetic foot were assessed. Lesions were
classified according to Wagner classification. Data was analysed using Epidata software. From the 91
participants, 55 (61 %) were males and 36 (39%) females. Mean age was at 60. 12 ± 10. 19 years. Median
diabetes duration was 10 years (Interquartile range = 4.25 – 16.75). Wagner grade 1, 2, 3, 4 and 5 were
17.7%, 40.65%, 28.8%, 13.3% and 0% respectively. Commonest ulcer location was margins of foot
(31.87%). There was no statistically significant association between the pack years of cigarette smoking
males and severity of foot lesions (Spearman’s rank correlation coefficient = - 0.037, p = 0.82). Patients
with claw and hammer toe deformities had their ulcers located in fingertips and toes (p = 0.0185). But there
was no statistically significant association with flat foot deformity and ulcer distribution on any particular
anatomical area in the foot (p = 0.0511). In conclusion there is a statistically significant association between
toe deformities and ulcer occurrence in finger tips. No significant correlation between severity of smoking
and severity of foot lesions among males is present.
