EDTA减少老年糖尿病患者内踝骨折切口皮肤坏死

目的探讨依地酸钠钙（ethylene diamine tetracetic acid,EDTA）对老年糖尿病患者内踝骨折切口皮肤边缘坏死的作用。方法 2008—2010年共治疗28例患者,EDTA组和对照组各14例。EDTA组：男9例,女5例;平均67.07岁。对照组：男6例,女8例;平均67.79岁。两组患者均采用标准内踝关节经内踝尖＂L＂形手术切口,形成逆行皮肤全厚皮瓣。EDTA治疗组：取EDTA一支（5mL,1g）,以生理盐水1∶1稀释,200mg（2mL）均匀注射于皮瓣的皮下组织,然后缝合;对照组则常规缝合。术后3d、7d观察皮瓣情况,记录皮瓣的水肿程度、颜色是否发红、温度是否增高、有无水疱、坏死,进行对比。结果术后3d、7dEDTA组皮瓣的水肿程度和坏死率较对照组减少,其差异有统计学意义。结论 EDTA可以减少老年糖尿病患者内踝手术＂L＂形常规皮瓣的皮肤边缘坏死。

Effect of EDTA on Reduce the Necrosis of Skin Edge for Old Folks with Diabetes after Incision of Fracture of Medial Malleolus

Objective To investigate the effect of EDTA on reduce the necrosis of skin edge for old folks with dia- betes after incision of fracture of medial malleolus. Methods From 2008 to 2010,28 patients accepted internal fixation of medial malleolus. Reverse thick skin flaps were formed through standard L-type incision of medial malleolus, 14 cases （m/f~ 9/5 ,average age：67.07 years） were selected as treatmental group ,who injected EDTA 200 mg（2 mL） be- fore closed incision while 14 cases （m/f= 6/8,average age： 67.79 years） were selected as control group who injected nothing. We compared the edema,color,temperature ,blisters ,necrosis of flaps after 3 days and 7 days respectively. Results The ratio of edema and necrosis of skin in treatmental group were less than control group after 3 days and 7 days. Conclusion EDTA is effective to reduce the necrosis of skin edge for old folks with diabetes after L-type inci- sion of fracture of medial malleolus.