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采用负压伤口治疗与富血小板血浆注射联合治疗一名伴有膝下蜂窝织炎的截肢候选者的糖尿病足溃疡:一项病例报告研究

Healing of diabetic foot ulcer in an amputation candidate with below-knee cellulitis using combination of negative pressure wound therapy and platelet-rich plasma injection: A case report study.

作者信息

Faramarzi Mohammad Reza, Shotorbani Ahmad, Sayahi Mohsen, Boustanchi Farzam, Sofizadeh Babak, Zayer Salar

机构信息

MSN, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, East Azerbaijan, Iran.

MS, Wellness, Sport, and Health, Campus Di Rimini, University of Bologna, Bologna, Italy.

出版信息

Int J Surg Case Rep. 2025 Feb;127:110838. doi: 10.1016/j.ijscr.2025.110838. Epub 2025 Jan 3.

Abstract

INTRODUCTION AND IMPORTANCE

Diabetic foot ulcers, especially when complicated by cellulitis, pose a significant challenge in diabetes management, often leading to amputation. This case report highlights the successful treatment of a diabetic foot ulcer in an amputation candidate using a combination of negative pressure wound therapy and platelet-rich plasma injection, potentially reducing the risk of amputation in high-risk patients.

CASE PRESENTATION

A 62-year-old male with poorly controlled diabetes presented with a chronic diabetic foot ulcer and cellulitis. After surgical debridement, negative pressure wound therapy was initiated, followed by platelet-rich plasma injection into the wound bed. This combination therapy led to rapid granulation tissue formation and complete wound closure within 8 weeks, with no adverse events observed. The patient successfully avoided amputation.

CLINICAL DISCUSSION

Negative pressure wound therapy played a vital role in managing the complex wound by removing exudate, reducing edema, and promoting granulation tissue formation, thereby accelerating healing and preparing for skin grafting. Alongside careful wound care, negative pressure wound therapy aided infection control and patient recovery. Additionally, platelet-rich plasma therapy enhanced healing by providing growth factors and proteins that support cellular proliferation and collagen synthesis. This combination of negative pressure wound therapy and platelet-rich plasma therapy demonstrates the effectiveness of advanced wound care for patients with complex diabetic foot ulcers.

CONCLUSION

This case underscores the potential benefits of combining negative pressure wound therapy and platelet-rich plasma injection in managing diabetic foot ulcers complicated by cellulitis. Further studies are needed to validate the efficacy of this approach, which could significantly improve patient outcomes and reduce amputation rates in high-risk patients.

摘要

引言与重要性

糖尿病足溃疡,尤其是合并蜂窝织炎时,给糖尿病管理带来重大挑战,常导致截肢。本病例报告强调了对一名有截肢风险的糖尿病足溃疡患者成功采用负压伤口治疗和富血小板血浆注射联合治疗,这可能降低高危患者的截肢风险。

病例介绍

一名62岁男性,糖尿病控制不佳,出现慢性糖尿病足溃疡和蜂窝织炎。手术清创后,开始进行负压伤口治疗,随后向伤口床注射富血小板血浆。这种联合治疗导致在8周内迅速形成肉芽组织并完全闭合伤口,未观察到不良事件。患者成功避免了截肢。

临床讨论

负压伤口治疗在处理复杂伤口中发挥了至关重要的作用,通过清除渗出物、减轻水肿和促进肉芽组织形成,从而加速愈合并为植皮做准备。除了仔细的伤口护理外,负压伤口治疗有助于控制感染和患者康复。此外,富血小板血浆疗法通过提供支持细胞增殖和胶原蛋白合成的生长因子和蛋白质来促进愈合。负压伤口治疗和富血小板血浆疗法的这种联合证明了先进伤口护理对复杂糖尿病足溃疡患者的有效性。

结论

本病例强调了负压伤口治疗和富血小板血浆注射联合治疗糖尿病合并蜂窝织炎足溃疡的潜在益处。需要进一步研究来验证这种方法的疗效,这可能显著改善患者预后并降低高危患者的截肢率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8210/11772136/51d95f226cd1/gr1.jpg

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