Prospective Study of Evaluation of Diabetic Ulcer Severity Score in Predicting Outcome in Patients with Diabetic Foot Ulcer at ESICMC & H Kalaburgi

Background and Objectives: A number of foot ulcer classification systems have been devised in an attempt to categorize ulcers more effectively and allow effective comparison of the outcome of routine management. DUSS (diabetic ulcer severity score) is one of the latest wound-based system of classification which needs to be validated. Our aim was validation of the score with patient outcomes including healing and amputation. Methods: Total of 102 diabetic patients attending surgical outpatient clinic or admitted into the hospital with foot ulcers irrespective of duration of ulcer were included in the study. Necessary data was collected. DUSS score was calculated for each patient and analysis was done using SPSS package version 23. Results and interpretation: The mean age of the participants in the study is 58.373 years, with the highest incidence between the age groups 51 – 60 years. Among the study population, 74% were males and 26% were females. In our study there were 15 patients with DUSS Score 1, 49 with DUSS Score 2, 20 with DUSS score 3, 18 with DUSS score 4. Among DUSS Score one, all patients underwent debridement. Among DUSS Score two, 19 patients underwent debridement, 30 patients underwent Minor amputation (Rays Amputation). Among patients with DUSS score three, 15 patients underwent debridement, 4 patients underwent minor amputations (Rays / forefoot amputation) and one patient underwent major amputation (BKA/AKA). Among patients with DUSS score four, 13 patients underwent major amputations, 4 patients underwent debridement and one patient underwent minor amputation. In our Study, 27 patients were healed primarily, 13 patients underwent grafting and 44 underwent Amputations. Conclusion: DUSS scoring system provides an easy diagnostic tool for anticipating probability of healing /amputation and need for surgery by combining four clinically assessable wound-based parameters. It can be very helpful for the stratification of study groups depending on severity of ulcers and it provides a simple, streamlined approach in a clinical setting that requires no investigative equipment although subsequent adequate wound care is an indispensable prerequisite to the DUSS being a valid diagnostic tool.