The Effects Of Different Lower Extremity Arterial Disease And Tissue Microcirculation On Negative Pressure Therapy For Diabetic Foot Ulcer

Objective:To compare the effects of different lower extremity arterial disease and tissue microcirculation on negative pressure therapy for diabetic foot ulcer.Methods:Seventy-five patients with diabetic foot ulcer who were admitted to the endocrinology of Guangxi Zhuang autonomous region people’s hospital from November 2015 to November 2019 were selected.According to the results of ankle-brachial index,percutaneous oxygen partial pressure,and color doppler ultrasound,the patients were divided into three groups:A,B,and C.Group C had the most severe arterial disease and group A had the least.Each group underwent negative pressure treatment for 2 weeks.Photos were taken of the foot ulcer wound surface of each group before the negative pressure treatment,at the one weekend of negative pressure treatment and at the two weekend of negative pressure treatment.Image J graphic analysis software was used to measure ulcer area and granulation area,and general clinical data of patients were collected.Non-parametric test method was used to compare the change values of ulcer area and granulation area at different negative pressure treatment stages within and between groups.And analyze the relevant factors of change values of ulcer area and granulation area at the end of negative pressure treatment for 2 weeks.Results:(1)The decrease of ulcer area and the increase of granulation area of diabetic foot ulcer in three groups with different lower extremity arteri al lesions and tissue microcirculation at the end of 1 week negative press ure treatment and the end of 2 weeks treatment were significantly compar ed with those before treatment(P<0.05).(2)From the perspective of stage factors,no significant difference was found in the ulcer area reduction val ues of vascular lesion groups A and B in the comparison between the ch ange value at the end of 1 week negative pressure treatment and the cha nge value at the end of negative pressure treatment for 1 week and 2 we eks in the three groups(P<0.05).The ulcer area reduction value at the end of 1 week negative pressure treatment in the group C was less than that at the end of negative pressure treatment for 1 week and 2 weeks(P<0.05).The increase of granulation area at the end of 1 week treatment in g roup A and group B was greater than that at the end of treatment for 1week to 2 weeks(P<0.05),and no significant difference was found in gro up C(P>0.05).(3)In terms of group factors,there were statistically significa nt differences in ulcer area reduction and granulation area increase betwee n the three groups at the end of 1week negative pressure treatment(P>0.05).In addition,the decrease value of ulcer area,reduction rate of ulcer ar ea,increase of granulation area and increase rate of granulation area at th e end of 1week negative pressure treatment in group C were all lower th an those in group A and group B(P<0.05).(4)Spearman correlation analysis showed that the change value of ulcer area at the end of treatment for2 weeks was correlated with the duration of diabetes(r_s=-0.324)、ABI(r_s=0.247)and lower limb vascular ultrasound(r_s=-0.210)(P<0.05);The chan-ge value of granulation area at the end of treatment for 2 weeks was cor related with Tcp O2(r_s=0.331)(P<0.05).(5)Multiple linear regression analysi s showed that the independent influencing factors of ulcer area reduction at the end of 2 weeks negative pressure were ABI and diabetic course(P<0.05);The independent influencing factor of granulation area increment at the end of 2 weeks negative pressure was Tc PO2(P<0.05).Conclusion:The different degree of lower extremity arterial disease and tissue microcirculation has an important impact on the effect of negative pressure therapy on diabetic foot ulcer.The more severe the degree of vascular disease and tissue microcirculation disorder are,the worse the effect of negative pressure therapy are.Besides,Ankle-brachial index and Percutaneous oxygen partial pressure can be used to evaluate the degree of lower extremity arterial lesion and tissue perfusion.Among them,percutaneous oxygen partial pressure and ankle-brachial index have guiding significance for the efficacy of wound negative pressure therapy(VAC)in the treatment of diabetic foot ulcer,and are important influencing factors for wound healing.