Prevalence of ischemia in diabetic foot infection.

Foot infection is a common problem affecting diabetics. In addition to neuropathy, ischemia is a major factor contributing to the progress and morbidity of the disease. The aim of this study was to determine the prevalence of lower limb ischemia in patients with diabetic foot infection prospectively measuring the ankle-brachial pressure index (ABI). Over a 21-month period 60 patients were treated in the general surgical ward of Princess Basma Teaching Hospital. Ischemia was present in 35 of the 60 patients (58.4%). Among them 27 had moderate ischemia (ABI 0.5-0.9) and were treated successfully before further vascular workup. The other 8 patients had severe ischemia (ABI < 0.5) and required below-knee amputation because their feet were severely infected and not salvageable. This study confirmed the recommendation for early detection of lowerlimb ischemia in diabetics, especially those with foot infection, as it should improve the outcome of treatment. In addition to patient education and periodic foot examinations, estimating the ABI is an easy, reliable way to determine foot blood flow and to detect patients who require further vascular workup and treatment.