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根据局部条件选择不同类型皮瓣治疗糖尿病足缺损的临床效果。

Clinical effects of different types of flaps selected according to local conditions in the treatment of diabetic foot defects.

机构信息

Department of Orthopedics, Hand & Microsurgery, Xiangya Hospital, Central South University, Changsha, China.

National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.

出版信息

J Orthop Surg Res. 2024 Oct 8;19(1):634. doi: 10.1186/s13018-024-05122-y.

Abstract

BACKGROUND

The repair of diabetic foot defects (DFD) is a major challenge in clinical practice. The purpose of this study was to investigate the difference in clinical efficacy of different flap techniques in repairing DFD wounds, and to compare the difference in clinical efficacy of anterolateral thigh perforator flap (ALTP) in repairing DFD and non-DFD.

METHODS

This study is a retrospective clinical study of different types of flap reconstruction in patients with DFD admitted to our hospital from January 2010 to December 2021. A total of 40 patients with DFD and 43 patients with non-DFD were included in this study. Detailed preoperative basic information, intraoperative details, postoperative complications and long-term follow-up results were collected.

RESULT

The comorbidities, wound infection and wound duration of DFD group were more serious than those of non-DFD group. In addition, the incidence of complications was higher in DFD group, the wound healing time was longer, the aesthetic evaluation, the functional recovery rate of ankle joint and the sensory recovery effect of flaps were worse.

CONCLUSION

In this study, it is concluded that different flap techniques can obtain better clinical efficacy in repairing DFD wounds. Compared with non-DFD wounds, the postoperative risk of DFD wounds using free ALTP flaps is higher, but the risk can be reduced by reasonable preoperative vascular examination. Free flap can deal with various irregular wounds and provide more options for clinical repair.

LEVEL OF EVIDENCE

III, Case-control study.

摘要

背景

糖尿病足缺损(DFD)的修复是临床实践中的一大挑战。本研究旨在探讨不同皮瓣技术修复 DFD 创面的临床疗效差异,并比较穿支皮瓣(ALTP)修复 DFD 和非 DFD 的临床疗效差异。

方法

这是一项回顾性临床研究,纳入了 2010 年 1 月至 2021 年 12 月期间我院收治的 DFD 患者和非 DFD 患者。详细收集了两组患者的术前基本信息、术中细节、术后并发症和长期随访结果。

结果

DFD 组的合并症、创面感染和创面持续时间均比非 DFD 组严重。此外,DFD 组的并发症发生率更高,创面愈合时间更长,美观评价、踝关节功能恢复率和皮瓣感觉恢复效果更差。

结论

本研究认为,不同的皮瓣技术均可获得较好的 DFD 创面修复临床疗效。与非 DFD 创面相比,游离 ALTP 皮瓣修复 DFD 创面的术后风险更高,但通过合理的术前血管检查可降低风险。游离皮瓣可处理各种不规则创面,为临床修复提供更多选择。

证据等级

III,病例对照研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3aca/11462749/39d39ed531de/13018_2024_5122_Fig1_HTML.jpg

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