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糖尿病足溃疡采用外科清创术和标准化伤口护理的特点和结果。

Characteristics and outcomes of diabetic foot ulcers treated with surgical debridement and standardized wound care.

机构信息

Poursina Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran.

Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

Int Wound J. 2024 Apr;21(4):e14859. doi: 10.1111/iwj.14859.

Abstract

Diabetic foot ulcers (DFUs) pose a significant clinical challenge, often leading to amputations and hospitalisation. This study aimed to investigate the characteristics and outcomes of DFUs treated with surgical debridement and standardised wound care. This descriptive cross-sectional study focused on diabetic patients with appropriate vascular conditions, as determined by an Ankle Brachial Index >0.9. Based on their infection status, participants were admitted to Poursina Hospital in Rasht, Iran, and subjected to initial supportive measures, antibiotic therapy and surgical debridement. The study incorporated primary treatment with wet bandages, silver spray and fibrinolysin ointment. Statistical analysis employed SPSS 22 software. Most patients were male (54.7%) and under 60 years old (50.7%). Overweight status was prevalent in 69.3% of diabetic ulcer patients, amongst whom 48% underwent wrist debridement. The 64% and 36% of the cases had grade III and grade II Texas index. Moreover, 96% of patients exhibited signs of infection and were classified as Stage Texas B. Reoperation was necessary for 34.7% of patients. The mean hospital stay was 8.5 ± 7.55 days, and the average recovery time was 15.2 ± 15.19 days. Out of 75 patients, 10 were unable to return to limb function due to disability. In this study, around one-third of patients required secondary repair with grafts and flaps. A small number of them were unable to recover because of underlying disability, and the mean recovery time in other cases was 24 days. Future studies should follow up with patients for longer periods to assess long-term therapeutic outcomes and quality of life.

摘要

糖尿病足溃疡(DFU)是一个重大的临床挑战,常导致截肢和住院。本研究旨在调查经手术清创和标准化伤口护理治疗的 DFU 的特征和结局。本描述性横断面研究聚焦于血管条件适当的糖尿病患者,通过踝肱指数>0.9 确定。根据感染状态,参与者被收入伊朗拉什特的 Pour-sina 医院,并接受初始支持性措施、抗生素治疗和手术清创。该研究采用湿性绷带、银喷雾和纤维蛋白溶解酶软膏进行初始治疗。统计分析采用 SPSS 22 软件。大多数患者为男性(54.7%)且年龄小于 60 岁(50.7%)。超重状态在糖尿病溃疡患者中很普遍(69.3%),其中 48%接受了腕部清创术。64%和 36%的病例分别为 Texas 分级 III 级和 II 级。此外,96%的患者出现感染迹象,被归类为 Texas B 期。34.7%的患者需要再次手术。患者的平均住院时间为 8.5±7.55 天,平均康复时间为 15.2±15.19 天。在 75 名患者中,有 10 名因残疾无法恢复肢体功能。在这项研究中,约三分之一的患者需要通过植皮和皮瓣进行二次修复。少数患者因潜在残疾而无法康复,其余患者的平均康复时间为 24 天。未来的研究应该对患者进行更长时间的随访,以评估长期治疗效果和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da67/10993353/06c6c9613d4f/IWJ-21-e14859-g001.jpg

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