The role of LMWH in fate of diabetic foot infection

Abstract

Diabetic foot infection holds a big challenge for both the patient and the orthopedic surgeon. This study aimed to explore the possible causes and to evaluate the effectiveness of the treatment diabetic foot infection by use LMWH and antibiotic. Sixty two patients with established diabetic foot infection were registered. All patients with diabetic foot infection underwent immediate or delayed treatment with LMWH (Enoxaparin sodium). Evaluation of diabetic foot infection was done by; careful clinical examination, laboratory investigation, and measurement of percutanouse oxygen tension. According to timing of treatment with LMWH early or late, the patients were divided into three groups early(less than 2 weeks), within 2 weeks, and delayed (more than 2 weeks) treatments. From the total 62 patients, there were 39 females which represent 62.9 % and 23 males represent 37 % of total. Their age range was 28-64 years with the mean age of the patients was 43 years. Majority 42 patients represent (67.7%) of total in the 4rd and 5th decay. The duration between clinical presentation and time of start treatment in less than 2 weeks was 21 patients which represent 33.8% where good prognosis was present, within 2 weeks was 17 patients which represent 27.4% where good prognosis was present and more than 2 weeks was 24 patients which represent 38.75 majority of patients were bad prognosis was present. Good response in 69.3% this group was present within 2 weeks and less and start to get treatment with LMWH (Enoxaparin sodium) and the other group was 30.6% present late more than 2 weeks and start treatment too late and get bad response. In conclusion, the chief causes that stand behind diabetic foot infection which we revealed by our successive clinical, radiological, laboratory and active operative judgments in this study were The most common precipitating factors penetrating wound in planter surface of foot in 38 patients which represent 61.2% followed by trauma 12 which represent 19.3% followed by thermal injury by electrical source and wear tight shoes was 6 respectively which represent 9.6%. Early treatment with LMWH and antibiotic express a good response in all patients present within and less than 2 weeks because LMWH, can improve the capillary circulation in the ulcer margin, which positively influences the healing process of chronic foot ulcers in diabetic patients.