Incidence of factors favoring recurrent foot ulcers in diabetic patients

Background: Patients with foot ulcers have a high risk of relapse and amputation. Several studies have reported that 28 to 51 % of amputated diabetics will have a second amputation of the lower limb within five years of the first amputation. The purpose of this study was to assess the incidence of factors favoring relapse within two years. Material and methods: One hundred ten diabetic patients were treated for foot lesions in the Casablanca Ibn Rochd university hospital between 1997 and 2000. Ninety of these patients attended review consultations. Results: There were 42 cases of relapse (46.6 %). Male gender predominated in the relapse patients with a sex ratio of 3.2. Mean age at relapse was 55 years; 71.5 % of the patients had type 2 diabetes. Lesions observed were neuropathic ulcer (n = 23), arterial ulcer (n = 6), infected wounds (n = 13). Revealing factors were burns and wounds. The main risk factors were neuropathy (n = 23, 52 %), neuroarteriopathy (n = 12, 31 %), peur arteriopathy (n = 6, 12 %). Patients who relapsed (n = 42) were significantly different from patients who did not relapse (n = 48) for gender, presence or absence of neuropathy, and presence or absence of arteriopathy. Discussion: Secondary preventive measures against these risk factors, medical care, and specialized follow-up were satisfactory in these patients, our findings illustrate the importance of specialized management of diabetic patients with foot lesions. Adequate care of the lesions and preventive measures against risk factors are needed.