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非侵入性皮肤拉伸装置与负压伤口治疗技术联合应用于糖尿病足术后治疗

The Combined Use of a Non-Invasive Skin-Stretching Device and the Negative-Pressure Wound Therapy Technique in the Treatment of Postoperative Diabetic Foot.

作者信息

Wang Liangchen, Wang Chenrui, Chen Hongmei, Chen Ying, Li Juan, Xiao Li, Zhu Di, Yang Caizhe

机构信息

Department of Endocrinology, Air Force Medical Center, PLA, Beijing, 100142, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2021 Aug 5;14:3523-3532. doi: 10.2147/DMSO.S322757. eCollection 2021.

Abstract

OBJECTIVE

The present study explored the effectiveness of using a non-invasive skin-stretching device (NSSD) combined with negative-pressure wound therapy (NPWT) for the postoperative wound repair of diabetic foot (DF) gangrene.

METHODS

The treatment group in this study involved 42 patients with Wagner grade 3-4 and undergone concomitant toe amputation or debridement, who were given NPWT combined with the use of a NSSD. The control group comprised 42 patients with similar trauma areas (±20%) that were matched at a ratio of 1:1. Following surgery, these patients received NPWT combined with the use of conventional dressings. A comparison was made of the postoperative wound healing rates and wound healing times of the two groups, with Kaplan-Meier survival analysis being used to compare the healing rate over time.

RESULTS

The three-month wound healing rate was higher in the treatment group than in the control group (38 of 42 [90.5%] vs 25 of 42 [59.5%], p = 0.002), and the wound healing time was shorter in the treatment group (44 days [95% CI 40.0-48.0]) than that in the control group (76 days [95% CI 63.0-89.0], p = 0.000). Taking the end of the final NPWT as the starting point, the comparison of wound healing time revealed that this period was shorter in the treatment group than that in the control group and the difference was statistically significant (11 days [95% CI 9.0-13.0] vs 42 days [95% CI 23.0-ND], p = 0.000).

CONCLUSION

The use of the NPWT technique combined with a NSSD can shorten the wound healing time and improve the wound healing rate of gangrene patients during the postoperative wound repair period.

摘要

目的

本研究探讨使用无创皮肤拉伸装置(NSSD)联合负压伤口治疗(NPWT)对糖尿病足(DF)坏疽术后伤口修复的有效性。

方法

本研究的治疗组包括42例Wagner 3-4级且接受了同期截趾或清创术的患者,给予NPWT联合使用NSSD。对照组由42例创伤面积相似(±20%)的患者组成,以1:1的比例匹配。术后,这些患者接受NPWT联合使用传统敷料。比较两组的术后伤口愈合率和伤口愈合时间,采用Kaplan-Meier生存分析比较随时间的愈合率。

结果

治疗组的三个月伤口愈合率高于对照组(42例中的38例[90.5%]对42例中的25例[59.5%],p = 0.002),且治疗组的伤口愈合时间短于对照组(44天[95%CI 40.0-48.0])(76天[95%CI 63.0-89.0],p = 0.000)。以最后一次NPWT结束为起点,伤口愈合时间的比较显示治疗组短于对照组,差异有统计学意义(11天[95%CI 9.0-13.0]对42天[95%CI 23.0-ND],p = 0.000)。

结论

NPWT技术联合NSSD的使用可缩短坏疽患者术后伤口修复期的伤口愈合时间并提高伤口愈合率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030f/8352599/64956d4901dd/DMSO-14-3523-g0001.jpg

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