Armstrong D G, Lavery L A
Department of Orthopaedics, University of Texas Health Science Center, San Antonio 78284-7776, USA.
J Am Podiatr Med Assoc. 1998 Oct;88(10):483-8. doi: 10.7547/87507315-88-10-483.
The authors evaluated the time to healing and prevalence of complications in patients undergoing mechanically assisted, delayed primary closure of diabetic foot wounds compared with a similar population who received standard wound care. A total of 55 patients were enrolled for study, with 25 in the experimental group and 30 in the control group. Patients in the experimental (stretch) group underwent mechanically assisted primary closure of their wounds using a skin-stretching device. There was no difference between the stretch and control groups with regard to any descriptive characteristics, including wound chronicity. Although the wounds were over three times as large on average in the stretch group (P < .001), the stretch group reached full epithelialization approximately 40% sooner than the control group (26.4 +/- 16.0 versus 42.5 +/- 19.9 days; P < .002). Eighty-eight percent of patients in the stretch group experienced wound dehiscence, at a mean time of 1.8 +/- 0.6 weeks following mechanically assisted closure. However, patients who experienced dehiscence in the stretch group healed significantly faster than patients in the control group (27.4 +/- 16.7 versus 42.5 +/- 19.9 days; P < .007). The results of this study suggest that mechanically assisted closure of diabetic foot wounds may result in reduced healing time compared with healing by secondary intention.
作者评估了接受机械辅助延迟一期缝合的糖尿病足伤口患者的愈合时间和并发症发生率，并与接受标准伤口护理的类似人群进行了比较。共有55名患者参与研究，其中25名在实验组，30名在对照组。实验组（拉伸组）的患者使用皮肤拉伸装置对伤口进行机械辅助一期缝合。拉伸组和对照组在任何描述性特征方面均无差异，包括伤口慢性化程度。尽管拉伸组伤口平均大小是对照组的三倍多（P < .001），但拉伸组完全上皮化的时间比对照组早约40%（26.4 +/- 16.0天对42.5 +/- 19.9天；P < .002）。拉伸组88%的患者伤口出现裂开，平均发生在机械辅助缝合后的1.8 +/- 0.6周。然而，拉伸组中出现伤口裂开的患者愈合速度明显快于对照组（27.4 +/- 16.7天对42.5 +/- 19.9天；P < .007）。本研究结果表明，与二期愈合相比，机械辅助缝合糖尿病足伤口可能会缩短愈合时间。
