Surgical treatment for diabetic foot ulcers
10.3760/cma.j.issn.1674-6090.2013.06.005
- VernacularTitle:糖尿病足溃疡外科修复的临床分析
- Author:
Can WANG
;
Lei GUO
;
Jing LI
;
Xiaoshu PU
;
Zhengyan WANG
;
Maohua LI
- Publication Type:Journal Article
- Keywords:
Diabetic foot;
Pathogen analysis;
Wound bed preparation;
Wound repair
- From:
Journal of Endocrine Surgery
2013;7(6):458-462
- CountryChina
- Language:Chinese
-
Abstract:
Objective To get the experience of surgical treatment for diabetic foot (DF) ulcer.Methods Clinical data of 85 patiems (108 limbs in total) admitted in Department of Bum and Plastic Surgery in The First Affiliated Hospital of Chongqing Medical University from Jan 2010 to Dec 2012 were retrospectively analyzed.Results Wound culture results of the 85 patients were:bacteria in 142 limbs,and fungi in 7 limbs.The main bacteria cultured were staphylococcus aureus,escherichia coli,coagulase negative staphylococcus,enterococcus,pseudomonas aeruginosa,and acinetobacter baumannii.DF healing and Wagner classification was negatively correlated:the higher the class,the less the primary healing rate.The higher amputation rate were found in the higher class patients.The more delayed healing,and the longer the healing time and average hospital stay were also found in the higher class patients.85 patients underwent surgery:skin grafting in 45 cases (52.9％),flap in 8 cases (9.4％),skin repair + flap grafting in 7 cases,toe (limb) amputation in 28 cases,2 cases were sutured after debridement.All cases were cured after one or multiple surgeries.No recurrence was found during the follow-up of 10 days to 2 months.No delayed infection occurred to the repairments.The shape and weight bearing walking function were good.Conclusions The treatment of DF need to follow the principle of multidisciplinary cooperation,professional treatmem,systemic and local treatment.We need to pay attention to the etiology and prevention of the disease,focus on wound bed preparation,choose the best treatment.Early operation can significandy fascilitate wound healing.
