Discussion On The Treatment Mode Of Diabetic Foot Chronic Ulcer Of Lower Limbs

Objective:To explore the treatment of chronic lower extremity ulcers in diabetic patients,and to seek a systematic treatment mode for diabetic foot chronic ulcer of lower limbs.Methods:From September 2016 to December 2018,30 patients with diabetic foot chronic ulcer of lower limbs who underwent plastic surgery at the Second Affiliated Hospital of Kunming Medical University were randomly divided into the traditional treatment group(group A)and the vacuum sealing drainage VSD treatment group(Group B)。Among them,14 cases in group A and 16 cases in group B.On the basis of controlling the original disease of the patient,group A was given conventional debridement dressing treatment,split-thickness or full-thickness skin grafting was used to repair the wound;group B was treated with VSD for 1-2 course of treatmeng after debridement,after the granulation tissue of the wound is well grown,is given a skin graft repair plus VSD treatment,namely VSD-SG(skin grafting)-VSD mode.The wound preparation time,dressing changes,total hospitalization time and total hospitalization cost were compared between the two groups.The patients were followed up for an average of 6 months(4-8 months)after discharge,and the therapeutic effect,wound healing time and complication rate of the application of vsd-sg-vsd mode in the treatment of chronic ulcer of lower limbs of diabetic foot were analyzed by statistical methodsResults:The average wound preparation time of group A was 13.14±3.90 days during hospitalization,and the average wound preparation time of group B was 10.03±1.71 days;The average times of dressing changes were 17.64±12.36 times in group A and 6.06±3.04 times in group B.;The average total days of hospitalization in group A were 28.21±14.96 days,and the average total days of hospitalization in group B were 18.56±4.87 days;the data of each group were statistically significant(P<0.05).The average hospitalization cost in group A was 15362.75±8512.54 yuan,and the average hospitalization cost in group B was 22648.75±12542.52 yuan.The difference was not statistically significant(P>0.05).After discharge,patients were followed up by outpatient service and telephone for 4-8 months(an average of 6 months).The effective rate of postoperative treatment was 57.2%in group A and 87.5%in group B,and the difference was statistically significant(P<0.05).The average wound healing time of group A was 51.71 9.78 days,and that of group B was 40.06 5.79 days,the difference was statistically significant(P<0.05).The incidence of postoperative complications was 35.7%in group A and 25%in group B,with no statistically significant difference(P>0.05).Conclusion:For patients with diabetic foot ulcer Wagner 2-4,based on the control of the patient’s original disease,the treatment with VSD-SG-VSD mode has a good clinical effect.Compared with traditional treatment methods,it can shorten the preparation time of wound,reduce the number of dressing changes,shorten the wound healing time,reduce the pain of patients and the workload of medical workers,and at the same time,which is worthy of clinical promotion and application.