Outcomes of heel ulcers in people with diabetes visiting tertiary care diabetes center of Karachi, Pakistan

Objective: To determine the outcome of heel ulcers in people with diabetes. Materials and Methods: This retrospective cohort study was conducted at the Diabetic Foot Department of Baqai Institute of Diabetology and Endocrinology (BIDE), Karachi. Ethical approval was obtained from the Institutional Review Board of BIDE. Relevant records of all patients of both genders with diabetes aged 18–80 years and ulcer over the heel visiting the Diabetic Foot Clinic from January 2016 to December 2020 were retrieved from the hospital management system of BIDE for evaluation. Pre-designed proformas were filled and Statistical Package for Social Science version 20 was used to analyze data. Results: Overall data of 1073 diabetic people with heel ulcers was retrieved, among them the mean age was 57.95 ± 11.96 years, and 715(66.6%) participants were male. Type 2 diabetes was found in 821 (97.9%) participants and 548 (65.6%) had >10 years duration of diabetes. In regard to type of ulcer, 876 (81.6%) were neuropathic ulcers, 91 (8.5%) were ischemic, and 89 (8.3%) were neuroischemic ulcers. According to university of Texas classification wound classification, 725 (67.6%) fell in stage B followed by 238 (22.2%) in stage A. Regarding heel ulcer outcome, a majority of 459 (95.8%) healed without amputation and only 15 (3.1%) healed with major amputation. Conclusion: We found that the majority of the people with heel ulcers had a favorable outcome and healed without an lower extremity amputation.