Abstract

Diabetic foot ulcer has been defined as “an ulceration of the foot associated with neuropathy and different grade of ischemia andinfection.”2 The condition is usually secondary to diabetic neuropathy due to uncontrolled diabetes orpoorglycemic status. The site of ulcers in diabetes are typically seen at the area of foot which encounters constant pressure or repetitive trauma. We carried out this study to determine the utility of this scoring system in predicting the clinical outcome of diabetic foot ulcer in routine clinical setting. Materials and Methodology: This study was adopted as a clinical, prospective, observational, cohort study which was carried out in Out-Patient Department as well as Emergency Department at People’s college of Medical Sciences and Research Centre, Bhopal. The duration of the study has been set up around 22 months from December 2020 to September 2022. All the study participants were carefully selected based on the inclusion criteria and Written consent was obtained from all the study participants after explaining them nature and purpose of study. Results: The association between DUSS score and primary healing showed that the primary healing was significantly better in patients with low DUSS score (0,1) as compared to patients with DUSS score of 2 or above (p<0.05). Table – 5 correlated the association between DUSS score and plastic surgery. Therefore the results showed that plastic surgery was done in significantly higher proportions of cases with DUSS score 2 (36.4%), followed by 29% cases with DUSS score 3 (p<0.05). When DUSS score and minor amputation were correlated, it has been tabulated that the rate of minor amputation is relatively be higher in patients with DUSS score 3 and 4. The rate of toe amputation was higher in patients with DUSS score 3 whereas the rate of fore foot amputation was higher inpatients with DUSS score 4(p<0.05). Conclusion: Advancing age, duration of diabetes and untreated/improper treatment of diabetes mellitus are predictors of high DUSS score that is linked with poor clinical outcome in terms of need of debridement, plastic surgery and amputation. Hence, DUSS score can be a part of day-to-day practice in diabetic clinics to classify the ulcers early and plan the management of patients according to the predicted clinical outcome.

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