Summary： Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputa- tion. The aim ...Summary： Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputa- tion. The aim of the present study was to use vacuum sealing drainage （VSD） with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical effi- cacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Am- putations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol （PVA） foam dress- ing and polyurethane （PU） film, with continuous irrigation of 1：5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8-18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one pa- tient who suffered from severe septic shock. Emergent resuscitation was performed and the patient re- turned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenviroument and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection.展开更多
Background:Vacuum sealing drainage(VSD)and epidermal growth factor(EGF)both play an important role in the treatment of wounds.This study aims to explore the effects of the combination of VSD and EGF on wound healing a...Background:Vacuum sealing drainage(VSD)and epidermal growth factor(EGF)both play an important role in the treatment of wounds.This study aims to explore the effects of the combination of VSD and EGF on wound healing and the optimal concentration and time of EGF.Methods:We tested the proliferation and migration capacity of HaCaT and L929 cells at different EGF concentrations(0,1,5,10,and 100ng/ml)and different EGF action times(2,10,and 30min).A full-thickness skin defect model was established using male,30-week-old Bama pigs.The experiment included groups as follows:routine dressing change after covering with sterile auxiliary material(Control),continuous negative pressure drainage of the wound(VSD),continuous negative pressure drainage of the wound and injection of EGF 10min followed by removal by continuous lavage(V+E 10min),and continuous negative pressure drainage of the wound and injection of EGF 30min followed by removal by continuous lavage(V+E 30min).The wound healing rate,histological repair effect and collagen deposition were compared among the four groups.Results:An EGF concentration of 10ng/ml and an action time of 10min had optimal effects on the proliferation and migration capacities of HaCaT and L929 cells.The drug dispersion effect was better than drug infusion after bolus injection effect,and the contact surface was wider.Compared with other groups,the V+E 10min group promoted wound healing to the greatest extent and obtained the best histological score.Conclusions:A recombinant human epidermal growth factor(rhEGF)concentration of 10 ng/ml can promote the proliferation and migration of epithelial cells and fibroblasts to the greatest extent in vitro.VSD combined with rhEGF kept in place for 10min and then washed,can promote wound healing better than the other treatments in vitro.展开更多
Background: Bilayer artificial dermis promotes wound healing and offers a treatment option for chronic wounds. Aim: Examine the clinical efficacy of bilayer artificial dermis combined with Vacuum Sealing Drainage (VSD...Background: Bilayer artificial dermis promotes wound healing and offers a treatment option for chronic wounds. Aim: Examine the clinical efficacy of bilayer artificial dermis combined with Vacuum Sealing Drainage (VSD) technology in the treatment of chronic wounds. Method: From June 2021 to December 2023, our hospital treated 24 patients with chronic skin tissue wounds on their limbs using a novel tissue engineering product, the bilayer artificial dermis, in combination with VSD technology to repair the wounds. The bilayer artificial dermis protects subcutaneous tissue, blood vessels, nerves, muscles, and tendons, and also promotes the growth of granulation tissue and blood vessels to aid in wound healing when used in conjunction with VSD technology for wound dressing changes in chronic wounds. Results: In this study, 24 cases of chronic wounds with exposed bone or tendon larger than 1.0 cm2 were treated with a bilayer artificial skin combined with VSD dressing after wound debridement. The wounds were not suitable for immediate skin grafting. At 2 - 3 weeks post-treatment, good granulation tissue growth was observed. Subsequent procedures included thick skin grafting or wound dressing changes until complete wound healing. Patients were followed up on average for 3 months (range: 1 - 12 months) post-surgery. Comparative analysis of the appearance, function, skin color, elasticity, and sensation of the healed chronic wounds revealed superior outcomes compared to traditional skin fl repairs, resulting in significantly higher satisfaction levels among patients and their families. Conclusion: The application of bilayer artificial dermis combined with VSD technology for the repair of chronic wounds proves to be a viable method, yielding satisfactory therapeutic effects compared to traditional skin flap procedures.展开更多
BACKGROUND The management of vascular graft infections continues to be a significant challenge in a clinical situation.The aim of this report is to illustrate the novel vacuum sealing drainage(VSD)technique and rectus...BACKGROUND The management of vascular graft infections continues to be a significant challenge in a clinical situation.The aim of this report is to illustrate the novel vacuum sealing drainage(VSD)technique and rectus femoris muscle flap transposition for vascular graft infections,and to evaluate the prospective of future testing of this surgical procedure.CASE SUMMARY We report the case of a 32-year-old male patient,who presented a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure.Using the VSD and muscle flap transposition,the groin wound and vascular graft infection were finally treated successfully.CONCLUSION Our case report highlights that VSD technique and rectus femoris muscle flap transposition could be considered in patients presenting with a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure,especially in consideration of treatable conditions.展开更多
Objective: To study the effect of vacuum sealing drainage combined with biological dressings on the angiogenesis and inflammatory response after diabetic foot ulcer wound grafting. Methods: Patients with diabetic foot...Objective: To study the effect of vacuum sealing drainage combined with biological dressings on the angiogenesis and inflammatory response after diabetic foot ulcer wound grafting. Methods: Patients with diabetic foot who were treated in Sichuan Provincial People's Hospital between May 2014 and February 2017 were selected and randomly divided into vacuum drainage group and normal control group who received vacuum sealing drainage combined with biological dressings as well as conventional debridement and dressing change to deal with the wound respectively. Before treatment as well as 1 d, 3 d and 5 d after treatment, the wound tissue was collected to determine the expression of angiogenesis molecules, angiogenesis signaling pathway molecules and inflammatory response molecules. Results: 1 d, 3 d and 5 d after treatment, VEGF, VEGFR, CD105, MMP9, PI3K, AKT, cyclinD1, p38MAPK and NF-kB protein expression in wound tissue of vacuum drainage group were significantly higher than those of normal control group while COX-2, iNOS, TNF-α and IL-6 mRNA expression were significantly lower than those of normal control group. Conclusion: Vacuum sealing drainage combined with biological dressings promotes the angiogenesis and inhibits the inflammatory response after diabetic foot ulcer wound grafting.展开更多
Objective: To evaluate the effect of external fixation combined with vacuum sealing drainage on the trauma degree and bone metabolism in patients with open tibiofibula fracture. Methods:A total of 116 patients with op...Objective: To evaluate the effect of external fixation combined with vacuum sealing drainage on the trauma degree and bone metabolism in patients with open tibiofibula fracture. Methods:A total of 116 patients with open tibiofibula fracture who received surgical treatment in Luzhou People's Hospital between February 2015 and January 2017 were divided into control group (n=58) and study group (n=58) by random number table. Control group received debridement + external fixation, and study group received debridement + external fixation +vacuum sealing drainage. The differences in the levels of trauma indexes and bone metabolism indexes were compared between the two groups before and after treatment. Results: Before surgery, there was no statistically significant difference in serum levels of trauma indexes and bone metabolism indexes between the two groups. 1 week after surgery, serum acute phase protein Tf level of study group was higher than that of control group whereas CER, Hp and CRP levels were lower than those of control group;stress indexes NE and Cor levels were lower than those of control group;bone metabolism indexes P1NP, BGP and BALP levels were higher than those of control group whereas β-CTX level was lower than that of control group. Conclusion: External fixation combined with vacuum sealing drainage can effectively reduce fracture trauma and promote fracture end healing in patients with open tibiofibula fracture.展开更多
Objective: To explore the clinical effect of vacuum sealing drainage on free dermatoplasty in the donor-site of calf pedicled island flap. Method: From January 2016 to January 2018, a total of 70 patients undergoing r...Objective: To explore the clinical effect of vacuum sealing drainage on free dermatoplasty in the donor-site of calf pedicled island flap. Method: From January 2016 to January 2018, a total of 70 patients undergoing reconstruction of skin and soft tissue defects in ankles and legs with calf pedicle island flap in Foshan Traditional Chinese Medicine Hospital were selected into our research. Selected patients were divided into VSD group and pressure dressing group according to the order of surgery. The VSD group was treated with free skin grafting and vacuum sealing drainage after separation of donor-site flap. The pressure dressing group was treated with free skin grafting and traditional pressure dressing technology after the separation of donor-site flap. Visual acuity simulation scores (VAS) were observed and recorded on the 1st, 7th, and 14th day after surgery. The unpacking time, skin graft healing time, skin graft survival rate, infection rate and incidence of subcutaneous hematoma were compared between the two groups. Results: The VAS scores on the 7th and 14th day after surgery in the VSD group were lower than those in the pressure dressing group. The unpacking time and skin graft healing time of the VSD group were shorter than those of the pressure dressing group. The survival rate of skin graft in VSD group was higher than that in the pressure dressing group. The infection rate and the incidence of subcutaneous hematoma in the VSD group were lower than those in the pressure dressing group. Conclusion: Vacuum sealing drainage is beneficial to promote the healing of free skin grafts in the donor site of the calf pedicle island flap, relieve pain, reduce adverse reactions, safe and effective, and worthy of clinical promotion.展开更多
目的:探究基于行动研究法的健康管理联合负压封闭引流(Vacuum sealing drainage,VSD)技术对深度烧伤患者心理状态及创面修复效果的影响。方法:选取2021年9月-2023年6月笔者科室收治的98例深度烧伤患者,经随机单双号法分为常规组(单号,n=...目的:探究基于行动研究法的健康管理联合负压封闭引流(Vacuum sealing drainage,VSD)技术对深度烧伤患者心理状态及创面修复效果的影响。方法:选取2021年9月-2023年6月笔者科室收治的98例深度烧伤患者,经随机单双号法分为常规组(单号,n=49)和行动法组(双号,n=49),两组均实施VSD技术治疗,常规组采用常规护理干预,行动法组采用基于行动研究法的健康管理。比较两组患者疾病认知水平、负性情绪[自我感受负担量表(Self-perceived burden scale,SPBS)]、伤残接受度[伤残接受度量表(Acceptance of disability scale,AODS)]、生活质量[中文版精简烧伤健康量表(Burn specific health scale-brief,BSHS-B)]、创面美观度[温哥华瘢痕量表(Vancouver scar scale,VSS)]评分及护理满意度。结果:干预后,行动法组患者对疾病的认知情况评分、AODS、BSHS-B评分及护理满意度均高于常规组,SPBS、VSS评分均低于常规组,差异均有统计学意义(P<0.05)。结论:对行VSD治疗的深度烧伤患者采用基于行动研究法的健康管理,可明显提高患者的疾病认知和伤残接受度,调节其负性情绪,利于创面外观恢复及生活质量提升,患者满意度较高,值得推荐。展开更多
Objective: To discuss the effect of vacuum sealing drainage combined with intermittent insulin flushing on the expression of inflammatory factors and apoptosis factors in diabetic lower limb ulcer wound. Methods: A to...Objective: To discuss the effect of vacuum sealing drainage combined with intermittent insulin flushing on the expression of inflammatory factors and apoptosis factors in diabetic lower limb ulcer wound. Methods: A total of 48 patients with diabetic lower limb ulcer who were treated in the Endocrine Department of the hospital between January 2016 and January 2017 were divided into the control group and research group by random number table, 24 cases in each group. Control group received vacuum sealing drainage, and research group received vacuum sealing drainage combined with intermittent insulin flushing. The differences in the expression of inflammatory factors and apoptosis genes in the wound exudate were compared between the two groups before and after treatment. Results: Before treatment, the differences in the inflammatory factor contents and apoptsis gene expression in wound exudate were not statistically significant between the two groups of patients. After treatment, inflammatory factors IL-6, IL-1β, TNF-α, CRP, VCAM-1 and FGF2 contents in wound exudate of research group were lower than those of control group;apoptosis gene Bcl-2 mRNA expression in wound exudate of research group was higher than that of control group while Bax, p53 and Fas mRNA expression were lower than those of control group. Conclusions: Vacuum sealing drainage combined with intermittent insulin flushing can effectively reduce the local inflammatory response and promote the granulation cell proliferation in wound of patients with diabetic lower limb ulcer.展开更多
基金supported by a grant from the National Natural Science Foundation of China(No.81201393)
文摘Summary： Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputa- tion. The aim of the present study was to use vacuum sealing drainage （VSD） with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical effi- cacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Am- putations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol （PVA） foam dress- ing and polyurethane （PU） film, with continuous irrigation of 1：5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8-18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one pa- tient who suffered from severe septic shock. Emergent resuscitation was performed and the patient re- turned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenviroument and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection.
基金the National Natural Science Foundation of China(81972047,81603008,81572148).
文摘Background:Vacuum sealing drainage(VSD)and epidermal growth factor(EGF)both play an important role in the treatment of wounds.This study aims to explore the effects of the combination of VSD and EGF on wound healing and the optimal concentration and time of EGF.Methods:We tested the proliferation and migration capacity of HaCaT and L929 cells at different EGF concentrations(0,1,5,10,and 100ng/ml)and different EGF action times(2,10,and 30min).A full-thickness skin defect model was established using male,30-week-old Bama pigs.The experiment included groups as follows:routine dressing change after covering with sterile auxiliary material(Control),continuous negative pressure drainage of the wound(VSD),continuous negative pressure drainage of the wound and injection of EGF 10min followed by removal by continuous lavage(V+E 10min),and continuous negative pressure drainage of the wound and injection of EGF 30min followed by removal by continuous lavage(V+E 30min).The wound healing rate,histological repair effect and collagen deposition were compared among the four groups.Results:An EGF concentration of 10ng/ml and an action time of 10min had optimal effects on the proliferation and migration capacities of HaCaT and L929 cells.The drug dispersion effect was better than drug infusion after bolus injection effect,and the contact surface was wider.Compared with other groups,the V+E 10min group promoted wound healing to the greatest extent and obtained the best histological score.Conclusions:A recombinant human epidermal growth factor(rhEGF)concentration of 10 ng/ml can promote the proliferation and migration of epithelial cells and fibroblasts to the greatest extent in vitro.VSD combined with rhEGF kept in place for 10min and then washed,can promote wound healing better than the other treatments in vitro.
文摘Background: Bilayer artificial dermis promotes wound healing and offers a treatment option for chronic wounds. Aim: Examine the clinical efficacy of bilayer artificial dermis combined with Vacuum Sealing Drainage (VSD) technology in the treatment of chronic wounds. Method: From June 2021 to December 2023, our hospital treated 24 patients with chronic skin tissue wounds on their limbs using a novel tissue engineering product, the bilayer artificial dermis, in combination with VSD technology to repair the wounds. The bilayer artificial dermis protects subcutaneous tissue, blood vessels, nerves, muscles, and tendons, and also promotes the growth of granulation tissue and blood vessels to aid in wound healing when used in conjunction with VSD technology for wound dressing changes in chronic wounds. Results: In this study, 24 cases of chronic wounds with exposed bone or tendon larger than 1.0 cm2 were treated with a bilayer artificial skin combined with VSD dressing after wound debridement. The wounds were not suitable for immediate skin grafting. At 2 - 3 weeks post-treatment, good granulation tissue growth was observed. Subsequent procedures included thick skin grafting or wound dressing changes until complete wound healing. Patients were followed up on average for 3 months (range: 1 - 12 months) post-surgery. Comparative analysis of the appearance, function, skin color, elasticity, and sensation of the healed chronic wounds revealed superior outcomes compared to traditional skin fl repairs, resulting in significantly higher satisfaction levels among patients and their families. Conclusion: The application of bilayer artificial dermis combined with VSD technology for the repair of chronic wounds proves to be a viable method, yielding satisfactory therapeutic effects compared to traditional skin flap procedures.
文摘BACKGROUND The management of vascular graft infections continues to be a significant challenge in a clinical situation.The aim of this report is to illustrate the novel vacuum sealing drainage(VSD)technique and rectus femoris muscle flap transposition for vascular graft infections,and to evaluate the prospective of future testing of this surgical procedure.CASE SUMMARY We report the case of a 32-year-old male patient,who presented a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure.Using the VSD and muscle flap transposition,the groin wound and vascular graft infection were finally treated successfully.CONCLUSION Our case report highlights that VSD technique and rectus femoris muscle flap transposition could be considered in patients presenting with a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure,especially in consideration of treatable conditions.
文摘Objective: To study the effect of vacuum sealing drainage combined with biological dressings on the angiogenesis and inflammatory response after diabetic foot ulcer wound grafting. Methods: Patients with diabetic foot who were treated in Sichuan Provincial People's Hospital between May 2014 and February 2017 were selected and randomly divided into vacuum drainage group and normal control group who received vacuum sealing drainage combined with biological dressings as well as conventional debridement and dressing change to deal with the wound respectively. Before treatment as well as 1 d, 3 d and 5 d after treatment, the wound tissue was collected to determine the expression of angiogenesis molecules, angiogenesis signaling pathway molecules and inflammatory response molecules. Results: 1 d, 3 d and 5 d after treatment, VEGF, VEGFR, CD105, MMP9, PI3K, AKT, cyclinD1, p38MAPK and NF-kB protein expression in wound tissue of vacuum drainage group were significantly higher than those of normal control group while COX-2, iNOS, TNF-α and IL-6 mRNA expression were significantly lower than those of normal control group. Conclusion: Vacuum sealing drainage combined with biological dressings promotes the angiogenesis and inhibits the inflammatory response after diabetic foot ulcer wound grafting.
文摘Objective: To evaluate the effect of external fixation combined with vacuum sealing drainage on the trauma degree and bone metabolism in patients with open tibiofibula fracture. Methods:A total of 116 patients with open tibiofibula fracture who received surgical treatment in Luzhou People's Hospital between February 2015 and January 2017 were divided into control group (n=58) and study group (n=58) by random number table. Control group received debridement + external fixation, and study group received debridement + external fixation +vacuum sealing drainage. The differences in the levels of trauma indexes and bone metabolism indexes were compared between the two groups before and after treatment. Results: Before surgery, there was no statistically significant difference in serum levels of trauma indexes and bone metabolism indexes between the two groups. 1 week after surgery, serum acute phase protein Tf level of study group was higher than that of control group whereas CER, Hp and CRP levels were lower than those of control group;stress indexes NE and Cor levels were lower than those of control group;bone metabolism indexes P1NP, BGP and BALP levels were higher than those of control group whereas β-CTX level was lower than that of control group. Conclusion: External fixation combined with vacuum sealing drainage can effectively reduce fracture trauma and promote fracture end healing in patients with open tibiofibula fracture.
文摘Objective: To explore the clinical effect of vacuum sealing drainage on free dermatoplasty in the donor-site of calf pedicled island flap. Method: From January 2016 to January 2018, a total of 70 patients undergoing reconstruction of skin and soft tissue defects in ankles and legs with calf pedicle island flap in Foshan Traditional Chinese Medicine Hospital were selected into our research. Selected patients were divided into VSD group and pressure dressing group according to the order of surgery. The VSD group was treated with free skin grafting and vacuum sealing drainage after separation of donor-site flap. The pressure dressing group was treated with free skin grafting and traditional pressure dressing technology after the separation of donor-site flap. Visual acuity simulation scores (VAS) were observed and recorded on the 1st, 7th, and 14th day after surgery. The unpacking time, skin graft healing time, skin graft survival rate, infection rate and incidence of subcutaneous hematoma were compared between the two groups. Results: The VAS scores on the 7th and 14th day after surgery in the VSD group were lower than those in the pressure dressing group. The unpacking time and skin graft healing time of the VSD group were shorter than those of the pressure dressing group. The survival rate of skin graft in VSD group was higher than that in the pressure dressing group. The infection rate and the incidence of subcutaneous hematoma in the VSD group were lower than those in the pressure dressing group. Conclusion: Vacuum sealing drainage is beneficial to promote the healing of free skin grafts in the donor site of the calf pedicle island flap, relieve pain, reduce adverse reactions, safe and effective, and worthy of clinical promotion.
文摘目的:探究基于行动研究法的健康管理联合负压封闭引流(Vacuum sealing drainage,VSD)技术对深度烧伤患者心理状态及创面修复效果的影响。方法:选取2021年9月-2023年6月笔者科室收治的98例深度烧伤患者,经随机单双号法分为常规组(单号,n=49)和行动法组(双号,n=49),两组均实施VSD技术治疗,常规组采用常规护理干预,行动法组采用基于行动研究法的健康管理。比较两组患者疾病认知水平、负性情绪[自我感受负担量表(Self-perceived burden scale,SPBS)]、伤残接受度[伤残接受度量表(Acceptance of disability scale,AODS)]、生活质量[中文版精简烧伤健康量表(Burn specific health scale-brief,BSHS-B)]、创面美观度[温哥华瘢痕量表(Vancouver scar scale,VSS)]评分及护理满意度。结果:干预后,行动法组患者对疾病的认知情况评分、AODS、BSHS-B评分及护理满意度均高于常规组,SPBS、VSS评分均低于常规组,差异均有统计学意义(P<0.05)。结论:对行VSD治疗的深度烧伤患者采用基于行动研究法的健康管理,可明显提高患者的疾病认知和伤残接受度,调节其负性情绪,利于创面外观恢复及生活质量提升,患者满意度较高,值得推荐。
文摘Objective: To discuss the effect of vacuum sealing drainage combined with intermittent insulin flushing on the expression of inflammatory factors and apoptosis factors in diabetic lower limb ulcer wound. Methods: A total of 48 patients with diabetic lower limb ulcer who were treated in the Endocrine Department of the hospital between January 2016 and January 2017 were divided into the control group and research group by random number table, 24 cases in each group. Control group received vacuum sealing drainage, and research group received vacuum sealing drainage combined with intermittent insulin flushing. The differences in the expression of inflammatory factors and apoptosis genes in the wound exudate were compared between the two groups before and after treatment. Results: Before treatment, the differences in the inflammatory factor contents and apoptsis gene expression in wound exudate were not statistically significant between the two groups of patients. After treatment, inflammatory factors IL-6, IL-1β, TNF-α, CRP, VCAM-1 and FGF2 contents in wound exudate of research group were lower than those of control group;apoptosis gene Bcl-2 mRNA expression in wound exudate of research group was higher than that of control group while Bax, p53 and Fas mRNA expression were lower than those of control group. Conclusions: Vacuum sealing drainage combined with intermittent insulin flushing can effectively reduce the local inflammatory response and promote the granulation cell proliferation in wound of patients with diabetic lower limb ulcer.
