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定制型真空密封引流与真空密封引流治疗糖尿病足溃疡的比较:回顾性分析。

Comparison of customized vacuum sealing drainage and vacuum sealing drainage in the treatment of diabetic foot ulcers: a retrospective analysis.

机构信息

Department of Endocrinology, First Affiliated Hospital of Jinan University, Guangzhou, 510632, China.

School of Nursing, Jinan University, Guangzhou, 510632, China.

出版信息

J Orthop Surg Res. 2023 Oct 27;18(1):803. doi: 10.1186/s13018-023-04298-z.

Abstract

BACKGROUND

The prevalence of diabetic foot ulcers, a common, more serious chronic diabetes-related complication, is increasing. Vacuum sealing drainage (VSD) constitutes an effective adjunctive treatment for diabetic foot ulcers. Factors, such as poor glycemic control, ischemia, and infection prolong wound healing time, and VSD products are expensive and unaffordable for many patients.

OBJECTIVE

To compare the use of customized VSD and customized VSD in the treatment of diabetic foot ulcer.

METHOD

This retrospective study included 83 patients with diabetic foot ulcers in customized VSD (n = 44) and VSD (n = 39) groups. Baseline data, efficacy after 14 days, total treatment efficiency, final outcome (28 days after treatment, healing rate), average treatment cost, and hospitalization (days) of the two groups were compared. Factors affecting wound healing were analyzed.

RESULTS

No significant intergroup differences in the baseline data were detected (VSD vs. customized VAD, p > 0.05). Treatment efficacy was higher in the customized VSD group than in the VSD group after 14 days (p < 0.05), although total treatment efficiency in both groups reached 100%. The final outcome in the customized VSD group was better (vs. VSD group, p < 0.05), and the wound healing rate was higher than in the VSD group (66.7% vs. 33.3%). The mean treatment cost and hospital days were greater in the VSD group (vs. customized VSD group; p < 0.05). Factors affecting wound healing include age, Wagner classification, HDL-C, and fasting C-peptide. Younger age, low Wagner classification grade, low HDL-C level, and high fasting C-peptide contribute to higher healing rate, CONCLUSION: Efficacy and final outcome of customized VSD were better than that of VSD; the customized VSD device is simple and convenient to operate, and enables cost-effective treatment.

摘要

背景

糖尿病足溃疡是一种常见且更为严重的慢性糖尿病相关并发症,其患病率正在上升。负压封闭引流(VSD)是治疗糖尿病足溃疡的有效辅助治疗方法。血糖控制不佳、缺血和感染等因素会延长伤口愈合时间,而且 VSD 产品昂贵,许多患者无法负担。

目的

比较定制 VSD 和 VSD 在治疗糖尿病足溃疡中的应用。

方法

本回顾性研究纳入了 83 例接受定制 VSD(n=44)和 VSD(n=39)治疗的糖尿病足溃疡患者。比较两组患者的基线资料、治疗 14 天后的疗效、总治疗有效率、最终结局(治疗后 28 天,愈合率)、平均治疗费用和住院时间(天)。分析影响伤口愈合的因素。

结果

两组患者的基线资料无显著差异(VSD 组与定制 VAD 组,p>0.05)。治疗 14 天后,定制 VSD 组的治疗效果优于 VSD 组(p<0.05),但两组的总治疗有效率均达到 100%。定制 VSD 组的最终结局更好(VSD 组,p<0.05),愈合率高于 VSD 组(66.7%比 33.3%)。VSD 组的平均治疗费用和住院时间均大于定制 VSD 组(p<0.05)。影响伤口愈合的因素包括年龄、Wagner 分级、高密度脂蛋白胆固醇(HDL-C)和空腹 C 肽。年龄较小、Wagner 分级较低、HDL-C 水平较低、空腹 C 肽较高与较高的愈合率相关。

结论

定制 VSD 的疗效和最终结局优于 VSD;定制 VSD 装置操作简单方便,具有成本效益。

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