الفهرس 
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Abstract
SUMMARY
D
FU is a frequent DM complication that has been rising over the past few decades. 15% of diabetic people are predicted to experience DFU at some point in their lives. According to estimates, DFU accounts for 20% or so of hospital admissions among DM patients. In fact, if the proper treatment is not given, DFU can result in infection, gangrene, amputation, and even death.
Once DFU has formed, there is a higher chance of ulcer advancement, which might eventually result in amputation. Overall, people with DM had a 15 times greater risk of lower limb amputation than patients without the disease.
For successful care of DFU, early detection, accurate assessment, prompt intervention, and thorough follow-up are essential.
Good glycemic control, normalisation of blood pressure, treatment of dyslipidemia, quitting smoking, and a healthy diet are all crucial components of the overall therapy strategy for diabetic ulcers. Appropriate nutrition should always be a part of the treatment strategy since malnutrition is a significant barrier to proper recovery.
When focused on elderly patients (> 70 years of age), the prevalence of PAD rises to between 15 and 20% from the general population’s 3 to 10% prevalence. The most severe type of PAD, known as CLTI, is an arterial obstruction that significantly restricts blood flow to the extremities (hands, feet, and legs), causes excruciating discomfort, and may potentially lead to skin sores or ulcers. The risk of significant cardiovascular ischemic events, chronic non-healing wounds, and major amputation is elevated in patients with CLTI. According to studies, 8% to 29% of diabetic people who develop a foot ulcer go on to require a major amputation. Amputation rates at 4 years range from 35% to 67% and death rates from 52% to 64% for CLTI with tissue loss.
So revascularization of the damaged extremity is therefore essential for preventing limb loss, extending survival, and enhancing quality of life.
So, several classifications have been issued to predict the risk of amputation in patient with DFUs. Recently The society of vascular surgery (SVS) published a classification where the amputation risk and clinical care are stratified based on three key factors: wound, ischemia, and foot infection (WIFI). The goal of implementing this classification system is to make it easier to analyze the outcomes of various types of therapy.
In this one arm observational prospective cohort study; 50 patients were selected from the Ain Shams University Hospitals either at OPC or ER. Patients were classified according to WIfI classification into 4 clinical stages according to the state of the ischemia, wound and foot infection.
Our results showed that:
The mean of age was 59.64 ± 8.81 years. 38 patients (76%) were male while 12 patients (24%) were female.
Regarding the past medical history, current Smoking was found in 27 patients (54%). Diabetes mellitus was found in all the patients. Hypertension was found in 38 patients (76%). Cardiac diseases were found in 24 patients (49%). Renal diseases (CKD) were found in 7 patients (14 %).
The patients were classified according to WIfI classification into four groups stage I-IV and their percentage 6%, 12%, 40%, 42% respectively.
No complications were encountered during revascularization procedures.
Minor amputation in form of toes amputation and TMA occurred in 26 patients (52 %) out of fifty patients. 12 patients (24 %) went for major amputation.
During follow-up, complete wound healing was found in 37 patients (74%). The healing duration range 1- 5 months.
Limb salvage was achieved in 38 patients (76%) and lost in 12 patients (24%).
WIfI classification is highly predictor of limb salvageability. The percentage of cases underwent major amputation in stage I-IV was 0%,0%,16%,83% respectively While ulcer healing was 100%,85% and 52% respectively.