الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
This study included 100 patients admitted in Mansoura University Hospital an Emergency Hospital in Vascular surgery Unit from May 2002 to May 2004 by diabetic foot lesion for assessment of the ulcer depth , ischemia and infections as risk factors and predictor of outcome in management of diabetic foot. The patients were classification according to grade and stage (UT classification system) whereas (16 patients) were presented by stage A, (39 patients) by stage B, (37 patients) by stage C and (8 patients) by stage D; grade 0 were (7 patients) , grade I (20 patients), grade II (32 patients) and grade III (41 patients). Proper management according to grade and stage was done as follow: 15 patients were treated by conservative measurement (antibiotic alone or associated with drainage and debridement). 12 patients were treated by metatarsal head excision. 42 patients were treated by vascular reconstruction. 17 patients were treated by primary minor amputation (2patients did toe amputation, 10 patients did ray amputation and 5 patients did transmetatarsal amputation). 14 patients were treated by primary major amputation (4 patients did above knee amputation and 10 patients did below knee amputation). We can conclude and recommend the following . 1 Patient instruction in foot care, routine inspection of the feet, evaluation of circulation and aggressive treatment of foot ulcers, therapeutic foot wear and employment of a multiclisciplinary team has resulted in a significant reduction in the amputation rate. 2 Deep tissue culture appeared to exhibit a higher diagnostic sensitivity than superficial swab. 3 Angiography should be performed when the patients healing potential is poor. Vascular reconstruction, when technically feasible, is recommended for patients with chronic neuropathic ulcers associated with critical ischemia. 4 Primary major amputation should be reserved only for patients with extensive damage of the foot (loss of the heel, spread of gangrene to the lower leg or osteomylities of the tarsal bones or bones of the ankle) and all other patients should be considered for limb salvage. 5 The results of the study revealed that grade and stage affect the outcome of diabetic foot lesion. The higher the grade , the greater the number of amputation performed. 6 The UT classification, which combines grade and stage, is more descriptive to the lesion and adds to the predictive power of a wound classification system especially for lesions within the same grade level but at a different stages.