Sun Yan-Wei, Li Liang, Zhang Zhi-Hua
Department of Burns & Plastic Surgery, 117906Zibo Central Hospital, Zibo, Shandong, PR China.
Department of Vascular Surgery, 527527The Affiliated Qingdao Central Hospital of Qingdao University, Qingdao, Shandong, PR China.
Int J Low Extrem Wounds. 2022 Jun 15:15347346221109045. doi: 10.1177/15347346221109045.
This study explored the clinical effectiveness of antibiotic-loaded bone cement (ALBC) combined with vacuum-assisted closure (VAC) on the treatment of Wagner 3-4 diabetic foot ulcers (DFUs). This is a retrospective study, including 32 patients with Wagner 3-4 DFUs who had undergone treatment between August 2019 and June 2021. Patient age, sex, Hemoglobin A1c (HbA1c), body mass index (BMI), ankle brachial index (ABI), white blood cells (WBC), C-reactive protein (CRP) levels, comorbidities and wound closure methods were recorded. Patients were divided into the study group and control group according to the treatment modality. Patients in the study group received the combination treatment of ALBC and VAC, while patients in the control group received single VAC treatment. Clinical endpoints were assessed and compared between the two groups, including wound complete healing time and complications after operation. All patients were followed-up 6 months postoperation. Results showed that the mean healing time of the study group (44.20 ± 16.72 days) was shorter than that of the control group (64.00 ± 29.85 days) ( < .05). The infection rate of the study group on the 10th day postoperation was lower than that of the control group (6.67%, 47.06%, < .05). And there were no significant statistical differences between the two groups in terms of bleeding and necrosis complications postoperation ( = .603, = .603). Based on the findings, we conclude that the application of ALBC combined with VAC can facilitate wound healing in Wagner 3-4 DFUs patients. It can help to control wound infections and shorten wound healing time.
本研究探讨了载抗生素骨水泥（ALBC）联合负压封闭引流（VAC）治疗Wagner 3-4级糖尿病足溃疡（DFU）的临床疗效。这是一项回顾性研究，纳入了2019年8月至2021年6月期间接受治疗的32例Wagner 3-4级DFU患者。记录患者的年龄、性别、糖化血红蛋白（HbA1c）、体重指数（BMI）、踝肱指数（ABI）、白细胞（WBC）、C反应蛋白（CRP）水平、合并症及伤口闭合方法。根据治疗方式将患者分为研究组和对照组。研究组患者接受ALBC与VAC联合治疗，而对照组患者接受单纯VAC治疗。评估并比较两组的临床终点，包括伤口完全愈合时间及术后并发症。所有患者术后随访6个月。结果显示，研究组的平均愈合时间（44.20±16.72天）短于对照组（64.00±29.85天）（P<0.05）。研究组术后第10天的感染率低于对照组（6.67%，47.06%，P<0.05）。两组术后出血和坏死并发症方面无显著统计学差异（P=0.603，P=0.603）。基于这些发现，我们得出结论，ALBC联合VAC的应用可促进Wagner 3-4级DFU患者伤口愈合。它有助于控制伤口感染并缩短伤口愈合时间。
