SURGICAL-MANAGEMENT OF DIABETIC FOOT COMPLICATIONS - THE FAR NORTH QUEENSLAND PROFILE

Background: Foot complications in diabetes incur huge human and medica l costs. There is a high incidence of complicated diabetes mellitus in Far North Queensland, particularly in the indigenous communities. Met hods: An audit of 51 patients admitted to Cairns Base Hospital from Ju ly 1992 to December 1994 with diabetic foot complications requiring su rgical intervention was performed. Results: The majority of surgical p rocedures were for serious infections in neuropathic feet precipitated by minor trauma. Surgical procedures included debridement/drainage, m inor amputation, major amputation and arterial bypass. Half of the pat ients required more than one procedure and/or multiple admissions. Ave rage length of stay was 48 days. Indigenous patients were overrepresen ted in this audited group. Conclusions: Prevention or minimization of diabetic foot complications can be achieved only through improvement i n education and vigilance at all levels of the treatment process from community to hospital. Special attention to the needs of indigenous co mmunities with a high incidence of diabetes must be a feature of any f uture initiatives.