Goodall Richard J, Borsky Kim L, Harrison Conrad J, Mavromatidou Galini, Shirley Rebecca A, Ellard David R, Rodrigues Jeremy N, Chan James Kk
From the Department of Plastic Surgery, Stoke Mandeville Hospital, Aylesbury, United Kingdom.
Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
Plast Reconstr Surg Glob Open. 2024 May 20;12(5):e5842. doi: 10.1097/GOX.0000000000005842. eCollection 2024 May.
Free tissue transfer (FTT) for reconstruction of diabetic foot disease (DFD) is an emerging field to preserve the lower limb within this patient group. The design of future quantitative research and clinical services in this area must consider the needs, expectations and concerns of patients. This qualitative study explores patient experiences of FTT for reconstruction of DFD.
Semistructured interviews were conducted to explore patients' lived experiences of FTT for DFD. A purposive sampling strategy identified six patients who underwent FTT for recalcitrant DFD between September 2019 and December 2021 in a single center in the United Kingdom.
Three experiential themes emerged. Theme 1: "negative lived experiences of living with DFD" included frustration with the chronic management of nonhealing ulcers and fear regarding limb amputation. Theme 2: "surgery related concerns" included fears of reconstructive failure and subsequent amputation, as well as foot cosmesis and donor-site morbidity. Theme 3: "positive lived experiences following reconstruction" included the positive impact the reconstruction had on their overall life and diabetic control. All patients would repeat the process to obtain their current results.
This qualitative study provides first-hand insight into the lived experience of FTT for DFD, exploring both the negative and positive experiences and reasons for these. We found that FTT for DFD can be positively life-changing for affected individuals.
采用游离组织移植（FTT）重建糖尿病足病（DFD）是该患者群体中保留下肢的一个新兴领域。该领域未来的定量研究和临床服务设计必须考虑患者的需求、期望和担忧。这项定性研究探讨了患者接受FTT重建DFD的经历。
进行半结构式访谈，以探究患者接受FTT重建DFD的生活经历。采用目的抽样策略，确定了2019年9月至2021年12月期间在英国一家单一中心因顽固性DFD接受FTT的6名患者。
出现了三个体验主题。主题1：“DFD患者的负面生活经历”包括对慢性不愈合溃疡管理的挫败感以及对肢体截肢的恐惧。主题2：“与手术相关的担忧”包括对重建失败及随后截肢的恐惧，以及足部美观和供区并发症。主题3：“重建后的积极生活经历”包括重建对他们整体生活和糖尿病控制产生的积极影响。所有患者都愿意再次接受该治疗以获得目前的结果。
这项定性研究提供了对DFD患者接受FTT生活经历的第一手见解，探讨了负面和正面经历及其原因。我们发现，DFD患者接受FTT可对受影响个体的生活产生积极改变。
