Volume 25 , Issue 1 , June 2023 , Pages 93-104
Sangar Mohammed Rafiq 1 ; Omer Ali Rafiq Barawi 1 ; Hamid Ahmed Mahmood Jaff 1 ; Dahat Jamal Hawez 2
1 Department of Surgery, College of Medicine, University of Sulaimani, Sulaimaniyah, Iraq
2 Department of Medicine, College of Medicine, University of Sulaimani, Sulaimaniyah, Iraq
Background: Diabetes mellitus is a progressive disease with chronic complications such as
diabetic foot infection, a significant difficulty that inevitably leads to gangrene and amputations.
Objective: This study aims to determine microbial prevalence in diabetic foot infections,
identify the significance of aggressive surgical therapy and minor amputations in limb salvage
and the prevention of more proximal amputations, and identify predicting factors affecting the
outcome of these surgical processes. Methods: In this cohort study, microbiological samples
were collected from 62 patients with diabetic foot lesions who underwent debridement or minor
amputations to determine the prevalence of microorganisms in diabetic foot infections. Then,
they were followed up to determine the rate of saved limbs and the factors that affect the
outcomes and rate of complications. Results: infections were mainly caused by aerobic Grampositive bacteria (S. aureus) 53.5%, and aerobic Gram-negative bacteria of enterobacter species
40.4%. Regarding the outcome of surgical intervention, we found an 80.65% success rate of
saving the limb with a 30.6% complication rate. Risk factors such as high levels of
inflammatory markers and parameters of the severity of peripheral arterial disease showed
significant association with the rate of complications and poor outcomes. Conclusions:
Debridement and minor surgical amputations effectively prevent more proximal amputations in
diabetic foot infections with a high chance of good results. At the same time, the common
microorganism in our local population was S. aureus, followed by P. mirabilis, E. coli, and
Klebsiella species in diabetic foot infections.