微骨窗骨搬移联合负压封闭引流治疗糖尿病足：双中心回顾性队列研究

doi:10.3969/j.issn.1006-5725.2024.18.014

Abstract

Abstract:

Objective To assess the effectiveness of enhanced tibial transverse transport （TTT） in conjunction with vacuum-assisted closure （VAC） therapy for managing recalcitrant diabetic foot ulcers. Methods A retrospective analysis was conducted on data from diabetic foot patients with Wagner grade ≥2 who were treated at Beijing Chaoyang Hospital and Beijing Chaoyang Hospital of Integrated Traditional Chinese and Western Medicine between July 2020 and December 2022. The patients were categorized into three groups based on their treatment regimen： VSD treatment （VSD group）， modified TTT treatment （TTT group）， and combined application of TTT and VSD （combined group）. A one-year follow-up was performed to assess general data， ulcer area before and three months after surgery， ankle brachial index， visual analog pain score， as well as adverse events within one year post-surgery among the three groups. Results The VSD group consisted of 43 patients， while the TTT group consisted of 43 patients， and the combined group consisted of 42 patients. There were no statistically significant differences in baseline characteristics among the three groups （P > 0.05）. Patients in the VSD group had longer ulcer healing time， higher pain scores， lower ankle brachial index （P < 0.05）， larger ulcer area （P = 0.029）， and higher one-year ulcer recurrence rate compared to those in the TTT group. On the other hand， patients in the combined group had shorter ulcer healing time compared to those in the TTT group （P = 0.046）. However， there were no significant differences observed between these two groups regarding ulcer area （P = 0.362）， pain scores （P = 0.932）， ankle brachial index （P = 0.671）， and one-year ulcer recurrence rate （P = 0.710）. Conclusions The efficacy of modified TTT surpasses that of VSD in promoting ulcer healing， alleviating pain， and enhancing lower limb circulation. Furthermore， the combination of VSD with modified TTT demonstrates a potential to further expedite wound healing time.

Key words: diabetic foot, tibial transverse transport, vacuum sealing drainage, angiogenesis, debridement

CLC Number:

R687.3

Junpeng LIU,Xinru DU,Xingchen YAO,Ziyu XU,Fuchun PEI,Lin ZHANG,Hui. ZHAO. Micro⁃osteotomy bone transport combined with vacuum sealing drainage for the treatment of diabetic foot： A retrospective cohort study of 128 patients from two centers[J]. The Journal of Practical Medicine, 2024, 40(18): 2590-2596.

Figures/Tables 5

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References 39

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变量	VSD组（n = 43）	TTT组（n = 43）	联合组（n = 42）	P值
年龄/岁	64.3 ± 11.0	65.0 ± 13.7	61.9 ± 11.9	0.485
糖尿病病程/a	20.5 ± 8.4	21.0 ± 7.8	19.5 ± 8.3	0.696
糖尿病足病程/d	87.5 ± 72.7	93.0 ± 87.2	91.7 ± 81.2	0.962
性别/［例（%）］				0.826
男	29（67.4）	29（67.4）	26（61.9）
女	14（32.6）	14（32.6）	16（38.1）
血糖控制不佳/［例（%）］	31（72.1）	29（67.4）	28（66.7）	0.842
坏疽脚趾数量/［例（%）］				0.215
≥ 3	1（2.3）	1（2.3）	2（4.8）
2	9（20.9）	6（14.0）	8（19.0）
1	23（53.5）	19（44.2）	12（28.6）
0	10（23.3）	17（39.5）	20（47.6）

指标	VSD组（n = 43）	TTT组（n = 43）	联合组（n = 42）	P值
愈合时间（x ± s）/d	74.5 ± 20.0^*	59.9 ± 14.0	52.1 ± 15.2^*	< 0.001
溃疡面积/cm2
术前	13.0（8.0，19.0）	12.0（8.0，20.0）	12.0（6.0，16.0）	0.648
术后3个月	2.0（0，3.0）^*	0（0，0）	0（0，0）	0.006
P值	< 0.001	< 0.001	< 0.001	-
VAS/分
术前	6.0（5.0，7.0）	6.0（5.0，6.0）	5.5（5.0，7.0）	0.958
术后3个月	3.0（2.0，4.0）^*	1.0（0，1.3）	1.0（0，1.3）	< 0.001
P值	< 0.001	< 0.001	< 0.001	-
ABI/分
术前	0.54（0.47，0.61）	0.52（0.46，0.60）	0.55（0.48，0.61）	0.719
术后3个月	0.55（0.47，0.63）^*	0.65（0.57，0.74）	0.66（0.57，0.73）	< 0.001
P值	0.183	< 0.001	< 0.001	-
溃疡复发/［例（%）］	8（18.6）^*	2（4.7）	1（2.4）	0.710

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Micro⁃osteotomy bone transport combined with vacuum sealing drainage for the treatment of diabetic foot： A retrospective cohort study of 128 patients from two centers

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