Characteristics of diabetic foot ulcers in Western Sydney, Australia

Australia is ranked ninth of 39 countries in the Western Pacific region most affected by diabetes. Patients with diabetes are at high risk of developing foot ulcerations that can develop into non-healing wounds. Recent studies suggest that the lifetime risk of developing a diabetic foot ulcer is as high as 25%. Few studies have reported the prevalence of, risk factors and socioeconomic status associated with, diabetic foot ulcers in Australia. The aim of this study was to evaluate the characteristics of diabetic foot ulcers in a tertiary referral outpatient hospital setting in Western Sydney, Australia.

From January-December 2011, a total of 195 outpatients with diabetes were retrospectively extracted for analysis from the Westmead Hospital's Foot Wound Clinic Registry. Data on demographics, socioeconomic status, co-morbidities, foot ulcer characteristics and treatment were recorded on a standardised form.

Demographics and physical characteristics were: 66.2% male, median age 67 years (IQR: 56-76), median body mass index (BMI) of 28 kg/m(2) (IQR: 25.2-34.1), 75.4% had peripheral neuropathy and the median postcode score for socioeconomic status was 996 (IQR: 897-1022). Diabetic foot ulcer characteristics were: median cross sectional area of 1.5 cm(2) (IQR: 0.5-7.0), median volume of 0.4 cm(3) (IQR: 0.11-3.0), 45.1% on the plantar aspect of the foot, 16.6% UT Wound Grade of 0C to 3C (with ischaemia) and 11.8% with a Grade 0D to 3D (with infection and ischaemia) and 25.6% with osteomyelitis. Five patients required an amputation: 1 major and 4 minor amputations.

In accordance with other international studies, foot ulcers are more likely to present on the plantar surface of the foot and largely affect overweight older males with a long standing history diabetes in our outpatient hospital in Western Sydney.