Department of Orthopedic Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, 100038, China.
Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
Sci Rep. 2024 Aug 6;14(1):18171. doi: 10.1038/s41598-024-69150-8.
Enhanced recovery after surgery (ERAS) has been successfully integrated into a diverse array of surgical fields to improve the quality and efficacy of treatment intervention. Nonetheless, the application of the ERAS protocol for patients with diabetic foot ulcer (DFU) subsequent to undergoing surgical procedures has not been previously explored. Therefore, this study aimed to investigate the effect of an enhanced recovery protocol on perioperative outcomes in patients with DFU following surgical procedures. A retrospective analysis was conducted on 112 patients with DFU who underwent surgery between January 2020 and December 2021 at a tertiary referral care center. In total, 57 patients received standard perioperative care (the non-ERAS group), and 55 patients received ERAS care (the ERAS group). The primary outcomes included the length of stay (LOS), wound healing time, patient satisfaction, and costs, serving as the basis for assessing the effectiveness of the two approaches. Secondary outcomes included preoperative anxiety (APAIS score), nutritional status (PG-SGA), pain (NRS score), the incidence of lower-extremity deep vein thrombosis (DVT), the reduction in lower-limb circumference, and the activity of daily living scale (Barthel Index). The ERAS group exhibited significantly shorter LOS (11.36 vs. 26.74 days; P < 0.001) and lower hospital costs (CNY 62,165.27 vs. CNY 118,326.84; P < 0.001), as well as a higher patient satisfaction score and Barthel Index score (P < 0.05). Additionally, we found a lower APAIS score, incidence of DVT, and circumference reduction in lower limbs in the ERAS group compared to the non-ERAS group (P < 0.05). In comparison, the wound healing time, nutritional status, and pain levels of participants in both groups showed no significant difference (P > 0.05). By reducing the LOS and hospital costs, and by minimizing perioperative complications, the ERAS protocol improves the quality and efficacy of treatment intervention in patients with DFU who underwent surgical procedures.Trial registration number: ChiCTR 2200064223 (Registration Date: 30/09/2022).
术后加速康复（ERAS）已成功应用于多种外科领域，以提高治疗干预的质量和效果。然而，对于接受手术治疗的糖尿病足溃疡（DFU）患者，ERAS 方案的应用尚未得到探索。因此，本研究旨在探讨 ERAS 方案对接受手术治疗的 DFU 患者围手术期结局的影响。我们对 2020 年 1 月至 2021 年 12 月在一家三级转诊中心接受手术治疗的 112 例 DFU 患者进行了回顾性分析。其中 57 例患者接受了标准围手术期护理（非 ERAS 组），55 例患者接受了 ERAS 护理（ERAS 组）。主要结局包括住院时间（LOS）、伤口愈合时间、患者满意度和费用，以此评估两种方法的有效性。次要结局包括术前焦虑（APAIS 评分）、营养状况（PG-SGA）、疼痛（NRS 评分）、下肢深静脉血栓形成（DVT）的发生率、下肢周径的减少和日常生活活动量表（Barthel 指数）。ERAS 组的 LOS（11.36 天比 26.74 天；P<0.001）和住院费用（CNY 62165.27 比 CNY 118326.84；P<0.001）明显更低，患者满意度和 Barthel 指数评分更高（P<0.05）。此外，与非 ERAS 组相比，ERAS 组的 APAIS 评分、DVT 发生率和下肢周径减少均较低（P<0.05）。然而，两组患者的伤口愈合时间、营养状况和疼痛水平均无显著差异（P>0.05）。通过缩短 LOS 和住院费用，最大限度地减少围手术期并发症，ERAS 方案可提高接受手术治疗的 DFU 患者的治疗干预质量和效果。
ChiCTR 2200064223（注册日期：2022 年 9 月 30 日）。
