负压创面治疗联合高压氧治疗糖尿病足的临床疗效

目的 探讨负压创面治疗联合高压氧治疗糖尿病足的临床疗效.方法 采用回顾性病例对照研究分析江苏大学附属人民医院整形烧伤科自2013年2月至2017年12月收治的46例糖尿病足患者的临床资料,根据治疗方法分为对照组(24例)和联合治疗组(22例).糖尿病足创面按Wagner分级为3～5级;共46足.对照组采用控制血糖、抗感...     

负压创面引流技术在糖尿病足治疗中的作用

目的 分析应用负压创面引流技术和常规敷料治疗糖尿病足溃疡创面的疗效.方法 回顾性分析2008年5月至2010年5月在我院治疗的35例Wagner 3～5级糖尿病足患者资料.20例接受常规敷料治疗;15例接受负压创面治疗.通过创面愈合时间及截肢率评价疗效.结果 负压创面组平均创面愈合时间为(28.21±4.34)d,常规敷料组为(57.35±5.23)d.常规敷料组18例截肢,截肢率为90.00%,2例(10%)接受常规敷料治疗患者保肢成功,而负压创面组5例截肢,截肢率为33.33%,10例(86.67%)患者保留患肢功能.结论 负压创面治疗技术结合清创及适当的抗炎治疗,可以有效的降低糖尿病足患者的截肢率.     

不同负压创面治疗技术对糖尿病足的修复效果比较

目的：分析比较负压辅助闭合（Vacuum-assistedclosure,VAC）、负压封闭引流（Vacuumsealingdrainage,VSD）两种负压创面治疗（Negativepressurewoundtherapy,NPWT）对糖尿病足（Diabeticfoot,DF）的修复效果。方法：纳入2018年1月-2020年7月收治的80例DF患者作为研究对象,采用随机数表法进行简单随机抽样,将患者分为VAC组和VSD组,每组40例。两组均对创面进行NPWT,VAC组采用VAC法,VSD组采用VSD法。比较两组患者疗效,评估患者恢复情况,比较两组治疗前、治疗2周后血清细胞因子水平[内皮素-1(Endothelin-1,ET-1)、血管内皮生长因子（Vascular endothelial growth factor,VEGF）、肿瘤坏死因子α(Tumor necrosis factor α,TNF-α)]、氧化应激标志物[超氧化物歧化酶（Superoxidedismutase,SOD）、一氧化氮（Nitricoxide,NO）、脂质过氧化物丙二醛（Lipidperoxide malo...     

NPWT联合银离子敷料治疗糖尿病足部溃汤的疗效分析

目的 探讨负压创面治疗(NPWT)联合银离子敷料治疗糖尿病足部溃疡的临床效果.方法 选取2018年1月至2020年1月在我科手术治疗的18例Wagner分级为2～4级的糖尿病足部溃疡患者,创面清创后采用NPWT联合银离子敷料治疗,2个治疗周期后观察创面肉芽组织覆盖率、肉芽组织生长厚度、 细菌清除率及愈合时间.结果 所有...     

中西医结合治疗糖尿病足难愈创面49例临床观察

目的:观察肤疾骨宁片2号及肤疾骨宁膏对糖尿病足难愈创面愈合的疗效.方法:49例Ⅱ型糖尿病足难愈创面在综合治疗的基础上,应用内服肤疾骨宁片2号及外敷肤疾骨宁膏治疗.结果:49例中39例治愈,6例好转,4例无效.结论:肤疾骨宁片2号及肤疾骨宁膏可促进糖尿病足难愈创面的愈合.     

中药灌洗负压治疗糖尿病足创面的疗效观察

目的:观察中药灌洗负压治疗糖足创面的临床疗效。方法:将60例糖尿病足住院患者随机分为观察组30例和对照组30例。观察组给予常规基础及中药灌洗负压技术治疗,对照组给予常规基础及盐水灌洗负压治疗,疗程为21 d,观察两组患者全血白细胞计数、C反应蛋白、创面面积变化、创面缩小率、换药次数及创面局部各症状积分的变化情况。结果:近期疗效结果表明观察组总有效率96.67%,明显高于对照组的90%(P0.05)。两组患者创面局部各症状积分治疗前后对比,差异有统计学意义(P0.05)。治疗后,观察组WBC、CRP、创面面积及换药次数等观察指标分别为(5.86±1.37)×109/L、(4.59±1.10) mg/L、(5.81±2.01) cm~2、(5.33±0.92)次,均明显低于对照组,治疗后创面缩小率(25.06±5.91)%明显高于对照组。结论:临床上应用中药灌洗负压技术治疗糖尿病足创面,可以明显缩短创面愈合时间,提高愈合率,减少换药次数,减轻患者换药痛苦和医护人员工作量。在治疗上具有自己的特色和优势,值得临床进一步推广应用。     

改良负压封闭引流联合创面胰岛素滴注技术治疗糖尿病足的疗效评估与分析

目的评估与分析改良负压封闭引流联合创面胰岛素滴注技术治疗糖尿病足的临床疗效。方法纳入自2016-01—2019-12治疗的50例糖尿病足(2型糖尿病且足部溃疡至少2周),观察组28例清创后采用改良负压封闭引流联合胰岛素创面局部滴注治疗,对照组22例清创后采用改良负压封闭引流联合生理盐水创面局部滴注治疗。结果观察组肉芽组织覆盖率高于对照组,肉芽组织厚度大于对照组,细菌清除率高于对照组,差异有统计学意义(P0.05)。观察组治疗后TNF-α、IL-1β、IL-6、VCAM-1表达明显低于对照组,而VEGF、TGF、EGF表达高于对照组,差异有统计学意义(P0.05)。观察组采用皮瓣覆盖创面的比例低于对照组,且植皮成活率与皮瓣成活率高于对照组,差异有统计学意义(P0.05)。结论糖尿病足创面采用改良负压封闭引流联合胰岛素滴注灌洗技术治疗可获得满意的临床疗效,该方法既保留了负压封闭引流技术治疗创面的优点,又融入了持续灌洗技术的优点,同时加入了胰岛素起到降糖、抗炎促进创面愈合的作用,降低了并发症发生的风险。     

负压封闭治疗慢性难愈合创面

目的 :评价负压封闭对慢性难愈合创面的治疗效果。方法 :对 2 8例慢性难愈合创面应用负压封闭治疗。结果 :负压治疗后创面清洁迅速 ,5例创面经负压治疗后直接上皮化愈合 ,2 0例创面经植皮愈合 ,3例创面经局部皮瓣转移愈合 ,治愈率 1 0 0 %。结论 :负压封闭技术是一种安全、简便、有效的处理慢性难愈合创面的新方法。     

负压创面治疗技术的研究进展

负乐创面治疗技术（negative pressure wound therapy，NPWT）又称真空辅助闭合疗法（vacuum assisted closure）、吸引创面闭合疗法（suclion wound closure therapy）．是近几年来兴起的一种促进创面愈合的前沿技术。该技术足将吸引装置与特殊的伤口敷料连接后，使伤口保持在负压状态，可以改善创面微循环．促进创面肉芽生长，减少细菌定植和繁殖，保持伤口环境湿润，从而达到治疗创面的目的。国内外学者将负压创面治疗技术应用于多种急、慢性创面的治疗或促进移植皮肤、皮瓣的成活，均取得了良好的效果。     

门诊简易封闭负压治疗技术在创面修复中的应用

封闭负压治疗技术目前被广泛地用于临床。它是一种促进急、慢性创面愈合的方法,其目的是将创面的分泌物及时吸出,清除坏死组织,减轻水肿,产生的负压使组织靠近,     

A comparison of diabetic foot ulcer outcomes using negative pressure wound therapy versus historical standard of care

Diabetic foot ulcers (DFUs) are a leading cause of morbidity and hospitalisation among patients with diabetes. We analysed claims data for Medicare part B diabetic foot ulcer patients treated with Negative Pressure Wound Therapy at home (N = 1135) and diabetic foot ulcer patients from a published meta-analysis of randomised controlled wet-to-moist therapy. The expected costs of care for the two treatments were also compared. A significantly greater proportion of wounds treated with NPWT achieved a successful treatment endpoint compared with wet-to-moist therapy at both 12 weeks (39.5% versus 23.9%; P < 0.001) and 20 weeks (46.3% versus 32.8%; P < 0.001). NPWT-treated patients reached a successful wound treatment endpoint more rapidly, and the benefit was apparent in all wound sizes. Expected 20-week treatment costs for NPWT were similar to those for wet-to-moist therapy if one nursing visit per day for the latter is assumed but 42% less if two nursing visits per day are made. Thus, NPWT may improve the proportion of DFUs that attain a successful wound treatment endpoint and decrease resource utilisation by a given health care system compared with standard wet-to-moist therapy.     

Autologous wound margin point columnar full-thickness skin grafting combined with negative pressure wound therapy improves wound healing in refractory diabetic foot ulcers

Diabetic lower extremity ulcers (DLEUs) are a severe complication of diabetes mellitus (DM) and are difficult to heal. This study aimed to explore the efficacy of autologous point columnar full-thickness skin graft taken from the ulcer wound margin combined with negative pressure wound therapy (NPWT) in refractory DLEUs. This is a prospective cohort study. A total of 40 inpatients with refractory DLEUs were recruited in the Diabetes Foot Center of Guangxi Zhuang Autonomous Region People's Hospital from October 2019 to November 2021. According to the doctors' professional suggestions and the patients' personal wishes, these enrolled patients were divided into two groups based on different topical wound management: the graft group (n = 18) and the conventional wound therapeutic (CWT) group (n = 22). The efficacy evaluations included the time to complete re-epithelialization of the wound and healing speed within 14 days of graft treatment or after 14 days of graft treatment in the two groups. Before the treatment, the graft group had a significantly larger ulcer area than the CWT group [27.22 (15.28, 46.59) versus 10.92 (7.00, 24.93) cm², P < .01]. However, the time to complete wound re-epithelialization in the graft group was shorter than in the CWT group [58.22 ± 30.60 versus 86.09 ± 49.54 d, P < .05]. Meanwhile, the healing speed in graft group was markedly faster than in CWT group, whether within 14 days [0.60 (0.40, 0.92) versus 0.16 (0.07, 0.34) cm²/d, P < .01] or after 14 days of graft treatment [0.57 (0.45, 0.91) versus 0.13 (0.08, 0.27) cm²/d, P < .01]. However, the total treatment cost in the graft group was lower than in the CWT group [419.59 ± 137.20 versus 663.97 ± 497.02 $, P < .05]. The novel treatment modality of autologous full-thickness skin graft taken from the ulcer wound margin combined with NPWT has hereby proposed for the first time, and is a safe, effective, and reliable method with a good performance-to-cost ratio to promote wound healing and shorten the healing time for DLEUs.     

Randomized clinical study to compare negative pressure wound therapy with simultaneous saline irrigation and traditional negative pressure wound therapy for complex foot infections

The aim of this study was to compare the efficacy of different negative pressure wound therapy (NPWT) devices and NPWT with and without simultaneous irrigation in patients admitted to hospital with moderate and severe foot infections. Ninety patients were randomized in a 12‐week prospective, randomized noninferiority trial to compare wound healing in patients with moderate and severe infected foot wounds treated with NPWT after surgery. Inclusion criteria included ABI > 0.5 or toe pressures >30 PVR/mmHg, >18 years of age and exclusion included active Charcot arthropathy, collagen vascular disease, HIV, and hypercoagulable state. We compared two different traditional devices, NPWT‐K (KCI, VAC Ulta) and NPWT‐C (Cardinal, PRO), and NPWT‐I with saline irrigation (Cardinal, PRO). All patients had therapy delivered at 125 mmHg continuous pressure. In patients who received simultaneous saline irrigation (NPWT‐I), the administration rate was 15 ml per hour. The primary outcome was the proportion of healed wounds in 12 weeks. Secondary outcomes included surgical wound closure, number of surgeries, length of stay, and time to wound healing. Continuous data was presented as mean ± standard deviation. Analysis of variance was used to compare continuous variables and chi‐square to compare dichotomous variables with an alpha of 0.05. There were no differences in outcomes among NPWT‐I, NPWT‐C, and NPWT‐K groups in proportion of healed wounds (63.3%, 50.0%, 46.7% p = 0.39), surgical wound closure (83.3%, 80.0%, 63.3%, p = 0.15), number of surgeries (2.0 ± 0.49, 2.4 ± 0.77, 2.4 ± 0.68, p = 0.06), length of stay (16.3 ± 15.7, 14.7 ± 7.4, 15.3 ± 10.5 days, p = 0.87), time to wound healing (46.2 ± 22.8, 40.9 ± 18.8, 45.9 ± 28.3 days, p = 0.78). We did not identify any significant differences in clinical outcomes or adverse events between patients treated with different NPWT devices or NPWT with and without irrigation.     

Management of negative pressure wound therapy in the treatment of diabetic foot ulcers

Diabetic foot (DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers (DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these, negative pressure wound therapy (NPWT) is a useful adjunct in the management of chronic and complex wounds to promote healing and wound bed preparation for surgical procedures such as skin grafts and flap surgery. NPWT has shown remarkable results although its mechanisms of action are not completely understood. In this paper, we offer a complete overview of this medication and its implication in the clinical setting. We have examined literature related to NPWT concerning human, animal and in vitro studies, and we have summarized why, when and how we can use NPWT to treat DFUs. Further we have associated our clinical experience to scientific evidence in the field of diabetic foot to identify a defined strategy that could guide clinician in the use of NPWT approaching to DFUs.     

Clinical outcome of diabetic foot ulcers treated with negative pressure wound therapy and the transition from acute care to home care

Diabetic foot ulcers affect millions of people in the United States of America and impose tremendous medical, psychosocial and financial loss or burden. Negative pressure wound therapy (NPWT) is generally well tolerated and appears to stimulate a robust granulation tissue response compared with other wound healing modalities. This device may be a cost-effective adjunctive wound healing therapy. This literature review will focus on the clinical outcome of diabetic foot ulcers treated with NPWT, its implication in the transition from acute care to home care, factors that might influence clinical outcomes in home care as well as quality-of-life aspects in these patients. Patient care for diabetic foot ulceration is complex and necessitates multiprofessional collaboration to provide comprehensive wound care. It is clear that when we strive for limb preservation in this most high-risk population, it is important to have an available versatile, efficacious wound healing modality. There is a need for an easy transition from acute care to home care. Resources need to be combined in a collaborative and synergistic fashion to allow patient to perform many daily living activities while receiving the potential benefits of an advanced wound healing modality.     

自体组织移植联合负压创面治疗技术在创伤性创面治疗中的应用

目的：探讨自体组织移植联合负压创面治疗技术在治疗创伤性创面中的临床分析。方法：选择2010年4月-2012年4月笔者所在医院收治的创伤性创面患者64例,所有患者早期均采取负压创面治疗技术治疗,根据创面情况选择皮瓣移植手术或者皮片移植手术。结果：64例患者创面分泌物进行细菌培养,培养阳性患者37例,阳性率为57.81%;64例患者采取皮瓣移植手术患者30例、采取皮片移植手术患者34例,皮瓣移植手术优良率为96.67%,皮片移植优良率为88.24%,两者比较差异不具有统计学意义（P＞0.05）。结论：自体组织移植联合负压创面治疗技术能够促进创伤性创面的愈合,提高自体组织移植的成活率,值得临床推广运用。     

Surgical debridement,maggot therapy,negative pressure wound therapy,and silver foam dressing revive hope for patients with diabetic foot ulcer: A case report

Introduction and importanceDiabetic foot ulcers (DFUs), as one of the most debilitating complications of diabetes, can lead to amputation. Treatment and management of d DFUs are among the most critical challenges for the patients and their families.Case presentationThe present case report is of a 63-year-old man with a 5-year history of uncontrolled type 2 diabetes who has had DFU for the past three years on three sites of the left external ankle in the form of two deep circular ulcers with sizes of 6 × 4 cm and 6 × 8 cm, the sole as a superficial ulcer with a size of 6 × 3 cm, and the left heel as a deep skin groove. Moreover, the left hallux was completely gangrenous. The patient's ulcers were infected with Staphylococcus aureus and multidrug-resistant Pseudomonas aeruginosa. The patient was transferred to our wound management team. DFU was treated and managed using a combination of surgical debridement, maggot therapy, the Negative Pressure Wound Therapy (NPWT), and silver foam dressing. After three months and ten days, the patient's ulcers completely healed, and he was discharged from our service with the excellent and stable condition.Clinical discussionDFUs are caused by various pathological mechanisms, the monotherapy strategy would lead to a very low level of recovery. Therefore, DFU management requires multimodal care and interdisciplinary treatment.ConclusionBased on the present case report study's clinical results, wound-care teams can use the combination therapy applied in this case report to treat refractory DFU.