Edrees Khalid M, Alqahtani Alanood I, Alkhatieb Maram T
Research Department, Dr Khalid Edrees Medical Center, Jeddah, Makkah, Saudi Arabia.
Department of Surgery, Faculty of Medicine, King Abdelaziz University, Jeddah, Saudi Arabia.
Int J Low Extrem Wounds. 2023 Nov 6:15347346231211372. doi: 10.1177/15347346231211372.
Patients with diabetic foot ulcer (DFU) are prone to major complications including amputations. Traditional remedies (TR) have been used to treat DFU around the world. This study aims to identify the prevalence of TR among patients with DFU in our local cohort and its effect on DFU. 1408 patients were included in the analysis. Data were collected retrospectively from patients' medical records. DFU characteristics include grading ulcers using the Wagner scale (WG) and infections (cellulitis and osteomyelitis). Ulcer management (UM) includes medical treatment, self-medical treatment, traditional treatment, and medical-traditional treatment. The mean age of the cohort was 60 years (SD = 12.4). The mean duration of diabetes was 18.6 years (SD = 9.3) and the mean duration of open wounds was 206.9 days (SD = 545.6). The majority were males (71%) and had type 2 diabetes (96%, SD = .204). Forty-three percent of patients were treated with TR (29% were self-prescribed and 14% prescribed by a physician) while 48% had medical treatment and 10% were self-treated using medical treatment. More than two-thirds of the cohort had cellulitis and/or osteomyelitis at the time of presentation. The use of traditional treatment was significantly associated with higher WG (WG 4 OR = 1.936, 95% CI: 1.338-2.800; WG 5 OR = 2.937, 95% CI:1.614-5.346; < 0.05). Moreover, osteomyelitis was associated with medical-traditional treatment (OR = 1.608, 95% CI: 1.006-2.572; < 0.05) and increased wound depth (WG 3 OR = 1.969, 95% CI: 1.193-3.250; WG 4 OR = 1.874, 95% CI: 1.115-3.15; < 0.05). There is high use of TR for the treatment of DFU in our cohort. High Wagner-grade of foot ulcers and the presence of osteomyelitis were highly associated with DFU. This study showed for the first time the use of traditional potions by medical physicians. Both physicians and patients need to be made aware of the detrimental effects of using traditional methods on DFU.
糖尿病足溃疡（DFU）患者容易出现包括截肢在内的严重并发症。传统疗法（TR）已在全球范围内用于治疗DFU。本研究旨在确定我们本地队列中DFU患者使用传统疗法的患病率及其对DFU的影响。1408名患者纳入分析。数据从患者病历中回顾性收集。DFU特征包括使用瓦格纳量表（WG）对溃疡进行分级以及感染（蜂窝织炎和骨髓炎）。溃疡管理（UM）包括药物治疗、自我药物治疗、传统治疗以及药物 - 传统联合治疗。队列的平均年龄为60岁（标准差=12.4）。糖尿病平均病程为18.6年（标准差=9.3），开放性伤口平均持续时间为206.9天（标准差=545.6）。大多数为男性（71%），患有2型糖尿病（96%，标准差=0.204）。43%的患者接受传统疗法治疗（29%为自行用药，14%由医生开方），48%接受药物治疗，10%自行采用药物治疗。超过三分之二的队列患者在就诊时有蜂窝织炎和/或骨髓炎。使用传统治疗与较高的瓦格纳分级显著相关（瓦格纳4级，比值比=1.936，95%置信区间：1.338 - 2.800；瓦格纳5级，比值比=2.937，95%置信区间：1.614 - 5.346；P<0.05）。此外，骨髓炎与药物 - 传统联合治疗相关（比值比=1.608，95%置信区间：1.006 - 2.572；P<0.05）以及伤口深度增加相关（瓦格纳3级，比值比=1.969，95%置信区间：1.193 - 3.250；瓦格纳4级，比值比=1.874，95%置信区间：1.115 - 3.15；P<0.05）。我们的队列中使用传统疗法治疗DFU的比例很高。足部溃疡的高瓦格纳分级和骨髓炎的存在与DFU高度相关。本研究首次显示医生使用传统药剂的情况。医生和患者都需要了解使用传统方法对DFU的有害影响。
