点状嵌入式植皮联合VSD治疗糖尿病足疗效观察

Clinical Efficacy of Punctiform Embedded Skin Grafting in Combination with VSD in Treating Diabetic Foot

目的观察点状嵌入式植皮联合负压封闭引流技术(vacuum sealing drainage,VSD)治疗糖尿病足的临床疗效。方法对2016年1月-2016年12月庄河市中心医院内分泌科收治的62例Wagner1~3级糖尿病足患者创面予以清创治疗至新生肉芽组织生长良好后,改为点状嵌入式植皮联合VSD治疗,观察创面愈合时间及愈合效果。结果 62例患者创面均完全愈合,愈合时间为(23.73±4.72)d,其中于术后第3周愈合者28例,第4)周愈合者25例,第5周愈合者9例,部分创面愈后留有增生性瘢痕;随访2个月,所有患者均未复发。结论点状嵌入式植皮联合VSD治疗糖尿病足,可有效促进创面愈合,提高手术成功率,且无明显不良反应,值得临床推广应用。

Objective To observe the clinical efficacy of punctiform embedded skin grafting in combination with vacuum sealing drainage （VSD） in the treatment of diabetic foot. Methods Sixty two patients with diabetic foot admitted to Endocrinology Department of Zhuanghe Central Hospital between January 2016 and December 2016 were first treated with debridement until new granulation tissues grew well on the wound surface, then changed to the treatment of punctitbrm em- bedded skin grafting in combination with VSD. The wound healing time and clinical outcomes were observed. Results All 62 patients achieved complete healing with the average wound healing time of （23.73 ± 4. 72） d. 28 patients achieved wound healing in the third week post-surgery, 25 patients achieved wound healing in the fourth week post-surgery and 9 pa- tients recovered in the fifth week post-surgery, with hypertrophic scarring observed in some healed wounds. The two-month follow-up showed no recurrence of diabetic foot. Conclusion The punctiform embedded skin grafting in combination with VSD in treating diabetic foot can effectively promote the wound healing with a high surgery success rate and no obvious ad- verse effects, worthy of being promoted in clinical practice.