000			03768nam a22003497a 4500
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028			_b Phone: +255 28 298 3384
028			_b Fax: +255 28 298 3386
028			_b Email: vc@bugando.ac.tz
028			_b Website: www.bugando.ac.tz
040			_bEnglish _cDLC
041			_aEnglish
100			_aPhillipo L Chalya _915821
222			_a Diabetic foot ulcers prevalence pattern surgical management Tanzania
245			_aSurgical management of Diabetic foot ulcers: A Tanzanian university teaching hospital experience
260			_aMwanza, Tanzania: _bBioMed Central & _bCatholic University of Health and Allied Sciences [CUHAS – Bugando] _c24 September 2011
300			_aPages 1-7
490			_v BMC Research notes Volume 4 Issue 1
520			_aAbstract: Background: Diabetic foot ulcers (DFUs) pose a therapeutic challenge to surgeons, especially in developing countries where health care resources are limited and the vast majority of patients present to health facilities late with advanced foot ulcers. A prospective descriptive study was done at Bugando Medical Centre from February 2008 to January 2010 to describe our experience in the surgical management of DFUs in our local environment and compare with what is known in the literature. Findings: Of the total 4238 diabetic patients seen at BMC during the period under study, 136 (3.2%) patients had DFUs. Males outnumbered females by the ratio of 1.2:1. Their mean age was 54.32 years (ranged 21-72years). Thirty-eight (27.9%) patients were newly diagnosed diabetic patients. The majority of patients (95.5%) had type 2 diabetes mellitus. The mean duration of diabetes was 8.2 years while the duration of DFUs was 18.34 weeks. Fourteen (10.3%) patients had previous history of foot ulcers and six (4.4%) patients had previous amputations. The forefoot was commonly affected in 60.3% of cases. Neuropathic ulcers were the most common type of DFUs in 57.4% of cases. Wagner's stage 4 and 5 ulcers were the most prevalent at 29.4% and 23.5% respectively. The majority of patients (72.1%) were treated surgically. Lower limb amputation was the most common surgical procedure performed in 56.7% of cases. The complication rate was (33.5%) and surgical site infection was the most common complication (18.8%). Bacterial profile revealed polymicrobial pattern and Staphylococcus aureus was the most frequent microorganism isolated. All the microorganisms isolated showed high resistance to commonly used antibiotics except for Meropenem and imipenem, which were 100% sensitive each respectively. The mean hospital stay was 36.24 ± 12.62 days (ranged 18-128 days). Mortality rate was 13.2%. Conclusion: Diabetic foot ulceration constitutes a major source of morbidity and mortality among patients with diabetes mellitus at Bugando Medical Centre and is the leading cause of non-traumatic lower limb amputation. A multidisciplinary team approach targeting at good glycaemic control, education on foot care and appropriate footware, control of infection and early surgical intervention is required in order to reduce the morbidity and mortality associated with DFUs. Due to polymicrobial infection and antibiotic resistance, surgical intervention must be concerned.
700			_a Joseph B Mabula _922948
700			_a Ramesh M Dass _923309
700			_a Rodrick Kabangila _923057
700			_a Hyasinta Jaka _919670
700			_a Mabula D Mchembe _922908
700			_aJohannes B Kataraihya _923329
700			_a Nkinda Mbelenge _923231
700			_a Japhet M Gilyoma _922731
856			_uhttps://doi.org/10.1186/1756-0500-4-365
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999			_c19684 _d19684