Lázaro-Martínez José Luis, García-Madrid Marta, Bohbot Serge, López-Moral Mateo, Álvaro-Afonso Francisco Javier, García-Álvarez Yolanda
Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
Laboratoires URGO, 75116 Paris, France.
J Clin Med. 2023 Jan 29;12(3):1040. doi: 10.3390/jcm12031040.
To assess the patients' microcirculation evolution during the treatment with a sucrose octasulfate-impregnated dressing, fifty patients with neuroischaemic DFU treated with TLC-NOSF dressing were included in a prospective study between November 2020 and February 2022. TcpO values were measured on the dorsalis pedis or tibial posterior arteries' angiosome according to the ulcer location. TcpO values were assessed at day 0 and every 4 weeks during 20 weeks of the follow-up or until the wound healed. A cut-off point of tcpO < 30 mmHg was defined for patients with impaired microcirculation. The TcpO values showed an increase between day 0 and the end of the study, 33.04 ± 12.27 mmHg and 40.89 ± 13.06 mmHg, respectively, < 0.001. Patients with impaired microcirculation showed an increase in the tcpO values from day 0 to the end of the study ( = 0.023). Furthermore, we observed a significant increase in the TcpO values in the forefoot DFU ( = 0.002) and in the rearfoot DFU ( = 0.071), with no difference between the ulcer locations ( = 0.694). The local treatment with TLC-NOSF dressing improved the microcirculation in patients with neuroischaemic DFU, regardless of microcirculation status at the baseline, and in the forefoot, regardless of the location.
为评估使用八硫酸蔗糖浸渍敷料治疗期间患者的微循环演变情况,2020年11月至2022年2月期间,一项前瞻性研究纳入了50例接受TLC-NOSF敷料治疗的神经缺血性糖尿病足溃疡(DFU)患者。根据溃疡位置,在足背动脉或胫后动脉血管体上测量经皮氧分压(TcpO)值。在随访的20周内或直至伤口愈合,于第0天及之后每4周评估一次TcpO值。微循环受损患者的TcpO临界值定义为<30 mmHg。TcpO值在第0天至研究结束时有所升高,分别为33.04±12.27 mmHg和40.89±13.06 mmHg,P<0.001。微循环受损的患者在第0天至研究结束时TcpO值有所升高(P = 0.023)。此外,我们观察到前足DFU(P = 0.002)和后足DFU(P = 0.071)的TcpO值显著升高,溃疡位置之间无差异(P = 0.694)。使用TLC-NOSF敷料进行局部治疗可改善神经缺血性DFU患者的微循环,无论基线时的微循环状态如何,在前足也无论溃疡位置如何。