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伴有外周动脉疾病的血运重建和未血运重建的糖尿病足溃疡愈合率比较。

Healing rate comparison of revascularized and non-revascularized diabetic foot ulcers with peripheral arterial disease.

作者信息

Suhartono Raden, Kekalih Aria, Adriani Januar Rizky, Faruk Muhammad

机构信息

Division of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Department of Community Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.

出版信息

Surg Open Sci. 2023 Nov 20;16:235-241. doi: 10.1016/j.sopen.2023.11.008. eCollection 2023 Dec.

Abstract

BACKGROUND

Revascularization is important for the healing of diabetic foot ulcers with peripheral arterial disease because it aids in the restoration of the perfusion function of the leg tissues and can reduce the risk of cardiovascular complications. However, no Indonesian studies have been identified that exclusively discuss the effectiveness of revascularization for patients with this condition. This study aimed to compare the healing rates of diabetic foot ulcers with peripheral arterial disease in patients who received or did not receive revascularization.

METHODS

This cohort study included diabetic foot ulcer patients with peripheral arterial disease undergoing treatment at our institution who received or did not receive revascularization based on the wound, ischemia, and foot infection (WIfI) score criteria. Wound healing was considered complete re-epithelialization within six months of the procedure or consistent epithelialization for four consecutive weeks. Patients who required amputation within six months of observation were deemed to have failed therapy.

RESULTS

Each group contained 23 patients. The revascularization group exhibited a healing rate of 78.3 % (18 patients), while the non-revascularization patients had a rate of 26.1 % (6 patients). The wounds of revascularized patients were 14.944 (1.102-202.692) times more likely to heal than those without revascularization ( < 0.01). WIfI stage 2-3 patients showed an 11.926 (1.438-98.883) times increase in the likelihood of wound healing compared to stage 4 WIfI patients.

CONCLUSION

The wound healing rate was higher for revascularized patients than for non-revascularized patients, and the severity of the wound based on WIfI score affected patient wound healing.

摘要

背景

血管重建对于患有外周动脉疾病的糖尿病足溃疡愈合很重要,因为它有助于恢复腿部组织的灌注功能,并可降低心血管并发症的风险。然而,尚未发现有印度尼西亚的研究专门讨论血管重建对此类患者的有效性。本研究旨在比较接受或未接受血管重建的外周动脉疾病糖尿病足溃疡患者的愈合率。

方法

这项队列研究纳入了在我们机构接受治疗的患有外周动脉疾病的糖尿病足溃疡患者,这些患者根据伤口、缺血和足部感染(WIfI)评分标准接受或未接受血管重建。伤口愈合被认为是在手术六个月内完全重新上皮化或连续四周持续上皮化。在观察期六个月内需要截肢的患者被视为治疗失败。

结果

每组有23名患者。血管重建组的愈合率为78.3%(18例患者),而未进行血管重建的患者愈合率为26.1%(6例患者)。接受血管重建的患者伤口愈合的可能性是未接受血管重建患者的14.944(1.102 - 202.692)倍(P < 0.01)。与WIfI 4期患者相比,WIfI 2 - 3期患者伤口愈合的可能性增加了11.926(1.438 - 98.883)倍。

结论

接受血管重建的患者伤口愈合率高于未接受血管重建的患者,并且基于WIfI评分的伤口严重程度影响患者伤口愈合。

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