Muhammad Ahmad, Azfar Farough, Tariq Mahmood Rehan, Muhammad Yousuf, Khalid Mahmood Gill.
Wounds of Heel Never Heal in Diabetics.
J Surg Pak Jan ;6(3):19-22.

A comparative study of 56 patients with foot ulcers was carried out from February 2000 to June 2000, at Surgical Unit ll, Bahawal Victoria Hospital, Bahawalpur to assess the difference in outcome of heel and non-heel ulcers in diabetics. The patients were divided into two groups: Group A- patients with heel ulcers and Group B- patients having ulcers anywhere other than on heels. Feet in both the groups were graded according to Meggitt-Wagner classification. Patients with evidence of primary vascular disease were excluded. All the patients were X-rayed for bony involvement. Proper glycaemic control with proper antibiotic cover was ensured and results of interventions were recorded and analysed. Most of the patients who fulfilled the inclusion criteria (35 in group A and 21 in group B) did not know about the mode of initial lesion. Those with history of trauma were 25.7% in group A and 1996 in group B. In group A, 51.4% patients had deep ulcers as compared to 42.80%0 patients of the same grade in group B. Although gangrene was more common in group B, these patients underwent relatively less interventions. The percentages of below and above the knee amputations were higher in group A. The single mortality also occurred in a patient with heel ulcer. Mean duration of hospital stay was 27.3 and 16.6 days in group A and B respectively.

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