Management of diabetic foot ulcer in Babol, North of Iran: an experience on 520 cases

Foot ulcers (FU) are a significant complication of diabetes mellitus (DM) and a preceding factor leading to lower extremity amputation. The aim of this study was to evaluate the management of diabetic foot ulcer (DFU) in Babol, north of Iran. Five hundred twenty cases of diabetic foot ulcer that were hospitalized in two main teaching hospitals of Babol University of Medical Sciences from March 2005 to September 2011 were evaluated. Glycemic control, wound and foot care, ulcer treatment and site of amputation were determined and the collected data were analyzed. Four hundred forty seven (84%) had inappropriate glycaemic control. Three hundred-sixty-four (70%) received oral anti-diabetic drugs. Ulcer care was proper and improper in 46% and 54% of cases, respectively. Quality of foot care was inappropriate in 66% of patients. Most patients were treated surgically (85%) including debridement (28%) and amputation (57%). Major amputations were the most common (63%) and below knee amputation was more predominant (61%). The results show that diabetic foot ulcer management is not appropriate in this region, and the rate of amputation is relatively high. Improvement and organization of existing facilities are recommended.