Management and Outcomes of Diabetic Foot Complications Requiring Surgical Intervention at a Sudanese First-Level Hospital: A Prospective Clinical Audit.

Background and Aims: Diabetic foot complications, encompassing ulcers, abscesses, and tissue necrosis, are common and serious complications of diabetes mellitus that can significantly impact quality of life and potentially lead to amputation, particularly in the presence of risk factors and inadequate care. This prospective clinical audit evaluated the management and outcomes of diabetic foot complications at a first-level hospital in Hilaliya, Sudan. Methods: A prospective clinical audit of 15 patients requiring surgical intervention was conducted from August to November 2023. Data on demographics, ulcer characteristics, timeliness of care, hygiene in surgical procedures, antibiotic use, and patient education were collected and analyzed. Results: Patients had a median age of 54 years and interquartile range (IQR) of 40-65 years. Ulcers were reported in 46.7% of cases and abscesses in 20%. Multidisciplinary team assessments within 24 h were provided to 53.3% of patients. Timely surgical intervention was performed in 93.3% of patients. Hygiene in surgical procedures measures were documented in all cases and sterile field usage was recorded in 20%. Empirical antibiotics were prescribed to 93.3% of patients. Complete healing without complications occurred in 86.7% of cases and 13.3% underwent amputation. Regarding patient education, 46.7% of patients had limited awareness of foot care and 53.3% received no counseling. Conclusion: There are significant gaps in hygiene in surgical procedures (particularly sterile protocols) and patient education. Urgent institutional focus on interdisciplinary coordination, sterile technique enforcement, and structured education programs is needed to improve outcomes.