The in-patient profile of lower limb neurovascular disease in a Trinidadian population - abstract

ABSTRACT

Lower limb neurovascular disease is an extremely common problem in Trinidad, accounting for about 55 per cent of the surgical in-patient population. Because detailed information on the profile of these patients is not documented a prospective survey of lower limb disease was carried out among all patients admitted to 116 adult surgical beds over a 3-month period. A form was designed to collect demographic data, diagnosis, operations dressings, antibiotics and risk factors, and completed for each patient on admission and updated till discharge. Of a total of 203 patients with lower limb disease 7 with varicose vein as the underlying pathology were excluded. There were 100 males in the 196 cases and Afro-Trinidadians (75.5 per cent) were predominant over Indo-Trinidadians (21.4 per cent). Wet gangrene accounted for 36 per cent, other infections 30 per cent, non-healing ulcer 19 per cent, dry gangrene 9 per cent and rest pain 7 per cent. Trauma initiated 35 per cent of the septic lesions. Forty-two (21.4 per cent) patients had major amputations. Patients stayed in hospital for a long time (average 22.2 days), used dressings frequently (15.1 dressings per patient) and required considerable antibiotic medication (20.7 days). Diabetes mellitus was the commonest associated disease (63 per cent). Lower limb ischaemia and gangrene result in considerable cost to our medical institutions. Foot care especially in diabetics could reduce the incidence of these problems since trauma is often a precipitating factor (AU)