Department of Nursing, Second Hospital of Shanxi Medical University, No. 382 of Wuyi Road, Xinghualing District, Taiyuan, Shanxi Province, 030001, China.
Department of Nursing, Shanxi Medical University, Taiyuan, Shanxi Province, 030001, China.
J Orthop Surg Res. 2024 Nov 20;19(1):776. doi: 10.1186/s13018-024-05278-7.
This study aims to assess the significance of monitoring temperature change trends at various wound sites in the healing process of diabetic foot ulcers after microcirculation reconstruction surgery.
A retrospective analysis was conducted on individuals with diabetic foot ulcers who had been admitted to the Department of Orthopedics at the Second Hospital of Shanxi Medical University between July 2020 and February 2022. Temperature changes were regularly monitored at the center of the wound and the distal tibia of the ipsilateral lower leg to assess microcirculatory blood perfusion. Wound, ischemia, and foot infection (WIFi) grading was performed at admission and the final follow-up was to determine the value of temperature monitoring at various sites. Additionally, the formation of collateral microarterial vessels was monitored to determine their consistency with the observed trends in temperature differences. Follow-up assessments included the recurrence of ulcers, development of ulcers at different locations, re-amputation of the toe or limb, and diabetes-related mortality.
A total of 29 patients were included in the follow-up, with an average age of 57.14 ± 14.75 years and a follow-up period of 9.79 ± 4.13 months. Following microcirculation reconstruction surgery, as the microvascular network formed, the temperature difference between the center of the wound and the distal tibia on the same side gradually decreased, with no statistical difference observed at 4 weeks postoperatively. At both admission and the final follow-up, there was a significant reduction in the wound (W) and ischemia (I) grades within the WIFi classification. The temperature at the wound center showed progressive improvement as collateral microarterial vessels developed. During the follow-up period, there were 2 cases of ulcer recurrence, 1 case of an ulcer appearing at a different location, no cases of re-amputation of the toe or limb, and 2 diabetes-related fatalities.
Skin temperature monitoring offers a direct and reliable indication of microcirculatory blood perfusion. Its simplicity and cost-effectiveness make it a valuable tool for widespread use in evaluating wound healing following microcirculation reconstruction surgery.
本研究旨在评估在糖尿病足溃疡微循环重建术后的愈合过程中，监测各伤口部位体温变化趋势的意义。
回顾性分析 2020 年 7 月至 2022 年 2 月期间在山西医科大学第二医院骨科就诊的糖尿病足溃疡患者。定期监测伤口中心和同侧小腿远端的温度变化，以评估微循环血液灌注情况。入院时和最终随访时进行伤口、缺血和足部感染（WIFi）分级，以确定各部位体温监测的价值。此外，监测侧支微动脉血管的形成情况，以确定其与观察到的温度差异趋势的一致性。随访评估包括溃疡复发、不同部位出现溃疡、脚趾或肢体再次截肢以及与糖尿病相关的死亡。
共纳入 29 例患者进行随访，平均年龄为 57.14±14.75 岁，随访时间为 9.79±4.13 个月。微循环重建术后，随着微血管网的形成，同侧伤口中心与远端胫骨之间的温差逐渐减小，术后 4 周时无统计学差异。入院时和最终随访时，WIFi 分级中的伤口（W）和缺血（I）等级均显著降低。随着侧支微动脉的发展，伤口中心的温度逐渐改善。随访期间，有 2 例溃疡复发，1 例出现不同部位的溃疡，无脚趾或肢体再次截肢，有 2 例与糖尿病相关的死亡。
皮肤温度监测可直接、可靠地反映微循环血液灌注情况。其简单、经济的特点使其成为评估微循环重建术后伤口愈合的有价值的工具，值得广泛应用。
