Vol. 2, Issue 6, Part P (2016)

Abstract
Aim: To determine the clinical features and management of ulcers of the lower limb.Methods: This prospective cross sectional study which was carried in the Department of General Surgery, Shadan Institute of Medical Sciences India, for the period of 12 months. 100 patients of chronic leg ulcers were selected randomly with the help of computer generated random numbers from the patients attending OPD or took admission in surgical ward. After diagnosis of primary cause of the leg ulcers, management of ulcers by proper antibiotic coverage for gram positive, gram negative and anaerobic organisms, proper glycemic control, elevation of leg, compression bandaging, total cessation of smoking and causative drugs, nutritional support, vasoactive agents to restore blood flow, nerve stimulation, proper wound care with debridement slough excision and dressing. Results: The mean (mean±SD) age of the patients was 52.34±12.05 years with range 20-75 years and the median age was 52.0 years. Test of proportion showed that the proportion of the patients with age between 40-70 years (84%) was significantly higher (Z=9.51; p< 0.0001). Only 5% and 5% of the patients were with age<30 years and ≥70 years respectively. Thus leg ulcers were more prevalent in the age group 40-70 years. Test of proportion showed that proportion of males 85% was significantly higher than that of females 15% (Z=9.74; p< 0.0001). Thus the leg ulcers were more prevalent among males. Ulcers in the left leg (49%0 was higher than that of right leg (47%) but it was not significant (Z=0.28; p=0.77). Only 3% of the patients were having ulcers in both legs. Most of the patients (61%) had ulcer at foot followed by gaiter (20%) and leg (19%). (Z=6.14; p< 0.0001). Most of the ulcers were diabetic (37%) followed by venous (22%) (Z=2.31; p=0.01). Only 5% and 3% were malignant and trophic ulcers. Peripheral neuropathy (23%) was the most common type of ulcer followed by venous hypertension (22%). Only 1 (1%) case of sickle cell disease was found. Conclusion: With the availability of arsenal of investigation wide range of antibiotics and with ever improving dressing material, there is certainly a great improvement in treatment of chronic leg ulcers.