INTRODUCTION: Foot Infections are a major source of morbidity and a leading cause of hospitalization for persons with diabetes. Ulceration,infection,gangrene,amputation are signicant complications of diabetic foot.Charcot foot(neuropathic osteodystrophy)is another serious complication of long standing diabetes.it is a progressive condition characterized by joint dislocations,pathologic fractures and severe destruction of pedal architecture,which can lead to limb threatening conditions.Five Major Pedal Complications of diabetes are: 1) Diabetic foot ulcer 2) Diabetic foot infection 3) Diabetic charcot foot 4) Diabetic foot ischemia 5) Deformities MATERIALS AND METHODS : Cross sectional observational study of 25 patients with diabetic foot admitted in tertiary care hospital during the period of 6 months.Pediatric patients have been excluded from study.Evaluation n management done by classifying the disease according to wegner's classication for diabetic foot. Magitt-Wegner Classication of foot Ulcers(Table 1) Patients had been taken randomly from different wards in hospital.Data collected by taking proper history and clinical examination of foot,wound or ulcer.Age,sex,duration and type of diabetes,examination ndingd,grade,investigation including blood sugar,swabs from ulcer,X ray of foot and treatment carried out were recorded. Age Incidence in diabetic foot(Table 2) Incidence of diabetic foot according to Gender(Table 3) Diabetic Foot Infection according to cause (Table 4) Grading as per Wegner's Classication(Table 5) Culture and Sensitivity(Table 6) RESULTS: In present study ,Limbs were preserved in 12 out of 25 surgically treated diabetic foot patients.13(56%) out of 25 cases despite of proper medical management and repeated debridment had to undergo amputation due to gangrene and uncontrolled fulminant infections. In a Study Conducted by Dr. A.H Khan et al52(200 patients), 70% required debridment,out of which 48.5% undergo skin grafting and rest 30% required amputation of different levels. In a study(100 patients) conducted bt Dr.Rooh UL Muqim et al51,48% 0f patients required amputation. Modalities of Treatment(Table 7) MANAGEMENT OF 25 CASES OF DIABETIC FOOT PROBLEMS Original Research Paper Dr Sandipkumar Chaudhari* (MS, FMAS, FIAGES. FCCS) *Corresponding Author General Surgery KEYWORDS : Diabetic Foot,amputation,debridment,dressing,antibiotics VOLUME-8, ISSUE-12, DECEMBER-2019 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra Grade Description of the ulcer 0 Pre or Post ulcerative lesion completely epithelized 1 Supercial,Full thicknessulcer limited to the dermis,not extending to subcutis 2 Ulcer of the skin extending through the subcutis with exposed tendon or bone without osteomyelitis or abscess formation 3 Deep ulcers with osteomyelitis or abscess formation 4 Localised gangrene of the toes or the forefoot 5 Foot with extensive gangrene Age(Years) No.of Cases Percentages Upto 40 1 4% 41-50 10 40% 51-60 4 16% 61-70 6 24% 71-80 4 16% Total 25 100% Sex No.of cases Percentages Male 18 72% Female 7 28% Total 25 100 Causes No.Cases Percantages Infective 15 60% Ischemic 6 24% Neuropathy 2 8% Infective + Ischemic 1 4% Infective +Neuropathy 1 4% Total 25 100% Present Study Dr.Rooh UL Muqim et al study Grade No.of Patients Percentages No.of Patients Percentages 0 0 0% 6 6% 1 1 4% 14 14% 2 3 12% 25 25% 3 9 36% 30 30% 5 4 16% 4 4% Organism Cases Percentages Staphyococcus 11 44% Pseudomonas 6 24% Streptococcus 1 4% Klebsiella 3 12% No Growth 4 16% Present study Dr.A.H.Khan et al Study No. of cases Percetages No. of cases Percentages Dr Chirag Chaudhary MS Ortho. 44 X GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS Amputation Levels (Table 8) CONCLUSION: We can save maximum number of Limbs in diabtic foot infections with early recognization of Infection and treatment ,patient's education about foot infection and proper care,aggressive use of antibiotics and repeated debridment when required.Due to complexity and multifactorial pathogenesis of diabetic foot problems,despite sophisticated investigations and treatment modalities amputation rate is still higher. REFERENCES: 1. Evaluation and management of diabetic foot according to wegner’s classication a study of 100 cases Rooh-UL-Muqim ,Samson Grifn,Mukhtar Ahmed 2. Approach to Managing Diabetic Foot Complications,A study of 200 cases KHAN A.h.1,BAJWA G.R 3. A Study-Steps for avoiding foot ulcers by ramya,kannan 2007 4. Incidence,outcomes,and cost of foot ulcers in patients with diabetes by dr.scott d.ramsay 5. A comparison of two Diabetic Foot Ulcer Classication systems The wegner’s and the University of texas wound classication systems by Dr.Samson oyibo 6. Dinh T,Pham H veves A,Emerging treatments in diabetic wound care,wounds 2002;14 : 2-10 7. Pinzur MS.Amputations in the diabetic foot.In Boulton AJM,Rayman G(eds),The Foot in diabetes.4th edn.Chichester : Wiley, 2000 ;308-322. 8. Lipsky BA,Berendt AR,Deery HG,et al. Diagnosis and treatment of Diabetic foot Infections,Clin Infect Dis 2004 ;39:885-910 9. Saunders LJ,Mrdjencovich D,Anatomical patterns of bone and joint destruction in neuropthic diabetics.Diabets 1991 ; 40 :529A 10. Boulton AJM,Gries FA,Jervell JA.Guidelines for the diagnosis and outpatient management of diabetic peripheral neuopathy.Diabet Med 1998 :15 : 508-514 VOLUME-8, ISSUE-12, DECEMBER-2019 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra Incision & Drainage 2 8% - - Debridment 1 4% 43 21.5% STG + Debridment 9 36% 97 48.5% Amputation 11 44% 60 30% Amputation + STG 2 8% - - Total 25 100% 200 100% Present study Dr.Rooh UL Muqim study Prodedure No.of cases Percentage No.of cases Percentage Toe 4 31% 32 66.6% Transmeta tasal 3 23% - - Syme's 0 0% 5 10.4& Below Knee 3 23% 11 22.9% Above Knee 3 23 % - - Total 13 100% 48 100% X 45GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS