ABSTRACT
Background: There are various wound classification systems to assess the severity of diabetic foot ulcer and involve different factors specifically depth, site, presence of neuropathy, ischemia etc. Wagner’s system classification is the most widely used in grading of diabetic foot ulcers. Methods: The case study was carried out in the Department of Surgery, Geetanjali Medical College and Hospital, Udaipur. Results: 173 cases were enrolled in study and grade-3 Wagner’s ulcers were predominant. Males were predominant. Peripheral arterial disease was more common than peripheral neuropathy and both were found significantly associated with development of ulcers. Methicillin resistant Staphylococcus aureus and Klebsiella pneumoniae were most common isolates. MRSA exhibited maximum sensitivity to vancomycin, clindamycin and linezolid. Gram negative isolates exhibited maximum sensitivity to meropenems, piperacillin-tazobactam. Conclusions: This study conclude that prospective multicenter studies are required to assess the appropriate antibiotic regimen in diabetic foot ulcers and proper management of antibiotics must be started to decrease the incidence and development of MDR organisms.
ABSTRACT
Background:According to NNISS (National nosocomial infection surveillance study) study , the criteria should be for clean cases 2.1%, clean contaminated cases 3.3% contaminated cases 6.4% and dirty cases 7.1% Post-operative wound infection has been the greatest obstacle to advancement of surgery down the centuries. Lister introduced antiseptic methods for safe surgery. Methods: All the patients were studied form the time of their admission, till their discharge from the wards, and up to second and fourth week of follow up. Details of individual cases were maintained in the proforma. Routine investigation were done pre-operatively in all the patients. In patients below 40 years complete hemogram, urine routine, blood urea, Serum creatinine and blood sugars were done. The details of the surgical procedure, the duration of surgery and any contamination on table were noted. A second dose of antibiotic was repeated at the end of two hours of operation where the surgery exceeds 2 hours Results: In our study 50 patients were included in this study each of which belong to 10-50 group. 10% belong to 10-20 age group,20% from 21-30 group, 44% from 31-40 age group and 26% belong to 40-60 age group. In our study 44% associated risk factor isolated ,13.6% anemia, DM 45.4% , 9% obesity , bronchitis and 22.7% hypertension. In our study Staphylococcus aureus isolated from two cases and E. coli and P. aeruginosa were isolated from one cases. Conclusion: :- Our study conclude that, In the clean, clean non-contaminated , and contaminated surgeries, single dose of cefazolin with addition of metronidazole when there should be anaerobic coverage can be widely applied in the routine practice.