VSD联合自体游离皮片植皮治疗糖尿病足感染创面的临床研究

Clinical study of VSD combined with autologous free skin graft in the treatment of infected wounds of diabetes foot

目的探讨负压封闭引流术(vacuum sealing drainage,VSD)联合自体游离皮片植皮治疗糖尿病足感染创面的应用效果。方法回顾性分析2022年1月~2022年10月收治的60例糖尿病足患者的治疗经过,将其按治疗方案的不同分为观察组和对照组,每组30例,两组均进行糖尿病足的基础治疗,对照组加用VSD治疗,观察组采用VSD联合自体游离皮片植皮治疗,治疗6周后,对比两组临床疗效、创面愈合时间、溃疡面积、红肿范围、溃疡深度、疼痛程度、并发症情况。随访6个月,评价两组足部功能。结果(1)观察组治疗有效率100.00%,对照组治疗有效率83.33%(P<0.05);(2)观察组创面愈合时间(19.82±4.13)d,住院时间(19.35±3.25)d,显著短于对照组(P<0.05);(3)治疗前,两组溃疡面积、红肿范围、溃疡深度、疼痛程度无显著差异(P>0.05)。治疗后,两组溃疡面积、红肿范围、溃疡深度、疼痛程度均明显改善,且观察组改善更为明显,与对照组相比差异显著(P<0.05);(4)观察组并发症发生率10.00%,对照组并发症发生率26.67%(P<0.05);(5)随访6个月,两组足部功能评分在治疗后均显著好转,与治疗前相比差异显著,且观察组足部功能评分显著高于对照组(P<0.05)。结论VSD联合自体游离皮片植皮治疗糖尿病足感染创面临床效果明确,可减少创面愈合时间,修复溃疡面,减轻患者疼痛,促进患者足部功能的恢复,安全可靠,值得推广应用。

Objective To explore the application effect of vacuum sealing drainage(VSD)combined with free autologous skin graft in the treatment of infected wounds of Diabetic foot.Methods Retrospectively analyze the treatment process of 60 patients with diabetes foot admitted from January 2022 to October 2022,and divide them into observation group and control group according to different treatment schemes.30 cases in each group.Both groups received basic treatment for Diabetic foot.The control group was treated with VSD,and the observation group was treated with VSD combined with autologous free skin graft.After 6 weeks of treatment,compare the clinical efcacy,wound healing time,ulcer area,redness and swelling range,ulcer depth,pain level,and complications between the two groups.Follow up for 6 months to evaluate foot function in both groups.Results(1)The effective rate of treatment in the observation group is 100.00%,while the effective rate of treatment in the control group is 83.33%(P<0.05);(2)The observation group had a wound healing time of(19.82±4.13)days and a hospital stay of(19.35±3.25)days,which was signifcantly shorter than the control group(P<0.05);(3)Before treatment,there was no signifcant difference in ulcer area,redness and swelling range,ulcer depth,and pain degree between the two groups(P>0.05);After treatment,the ulcer area,redness and swelling range,ulcer depth,and pain degree in both groups were signifcantly improved,and the observation group showed more signifcant improvement,with a signifcant difference compared to the control group(P<0.05);(4)The incidence of complications in the observation group was 10.00%,while the incidence of complications in the control group was 26.67%(P<0.05).(5)After a follow-up of 6 months,the foot function scores of both groups improved signifcantly after treatment,with a signifcant difference compared to before treatment.The foot function scores of the observation group were signifcantly higher than those of the control group(P<0.05).Conclusion VSD combined with autologous free skin graft has a clear clinical effect in treating infected wounds of Diabetic foot,which can reduce the time of wound healing,repair the ulcer surface,alleviate the pain of patients,and promote the recovery of foot function.It is safe and reliable,and is worth popularizing.