摘要
目的比较无明显缺血的糖尿病足（diabetic foot,DF）行半趾截断手术后,切口皮缘是否缝合对创面愈合速度的影响。方法入组患者按手术先后序号,单号入缝合组,双号入对照组,共26例。缝合组13例：术后皮缘间隔1 cm缝合2-3针对合切口,隔日换药;对照组13例：采用术后创面开放,应用负压吸引促进肉芽填充,以瘢痕形式愈合。比较两组创面愈合时间。结果两组患者一般情况比较,差异无统计学意义（P均〉0.05）。缝合组中11例创面术后9-14 d一期愈合,平均时间（11±2）d,另2例出现皮缘逐渐发绀,脓性分泌物渗出,术后10 d拆线、清创,予以对照组方式处理,创面分别在手术后31 d、46 d愈合。对照组术后创面愈合时间18-30 d,平均（24±3）d。缝合组术后一期愈合的11例创面愈合时间短,与对照组比较差异有统计学意义（P〈0.05）。结论 DF行半趾离断术时,如患足血供可,创面无明显感染,术后切口皮缘对合良好,创面内部无明显腔隙,间断缝合治疗可明显缩短愈合时间,疗效满意。
Objective To compare wound healing rate in patients who had the toe amputation for diabetic foot ulcers with different treatments. Methods Twenty-six enrolled patients were divided into two groups, 13 cases of the skin suture group accepted skin interrupted suture after toe amputations, 13 cases of the control group accepted wound open after toe amputations and used vacuum sealing drainage. The speed of wound cure of the two groups was compared. Results The difference between the two groups of patients had no significant difference in the mean age, duration of diabetes, ABI,dorsalis pedis artery blood flow（P〈0.05）. Eleven cases of skin suture group were completely healed after 9-14 days at the average time of（11 ± 2） days, 2 cases had gradually cynosed skin edge of the wound, increased secretion from the wound. After the suture was removed, vacuum sealing drainage and dressing change, the wounds were cured after 31 days,46 days respectively. Thirteen of the control group cured in 18-30 days, with the average time of（24±3） days. The ulcer healing rate of skin suture group was 84.6%. The curing time of 11 cases in the skin suture group was shorter than that of the control group, the difference between the skin suture and the control group was statistically significant（P〈0.05）. Conclusion Skin suture is an effective treatment for wound healing after toe amputation for diabetic foot ulcer if the wound has enough blood supply and no obvious lacuna inside.
出处
《北京医学》
CAS
2015年第11期1078-1080,共3页
Beijing Medical Journal
