Clinical Effect Of Negative Pressure Wound Therapy Combined With Hyperoxic Fluid Lavage On Chronic Wounds Of Diabetic Foot In Plateau Area

Objective: To observe the effects of vacuum sealing drainage(VSD)combined with hyperoxia liquid lavage(HPSW)on chronic wound-related inflammatory factors and macrophage-related markers of diabetic foot in plateau areas.Methods: From 2019 to 2021,45 patients with chronic wounds of diabetic foot from the plateau area who were treated in the Department of Burn and Plastic Surgery,Qinghai University Affiliated Hospital were selected,and the 45 patients were randomly divided into 3 groups by random table method: negative pressure sealing wound treatment(There were 15 cases in the VSD)group,15 cases in the negative pressure sealing wound treatment group combined with 0.9% normal saline lavage(VSDNS)group,and 15 cases in the negative pressure sealing wound treatment group combined with hyperoxic lavage(VSDOS)group.Serum CRP level was detected by automatic biochemical analyzer 7600-020,serum PCT level was detected by immunoquantitative analyzer HR201,serum ESR content was detected by automatic erythrocyte sedimentation instrument Monitor100,and plasma D-dimer content was determined by immunoturbidimetric method,the expression levels of granulation tissue macrophage markers CD68,Arg-1,CD163 and i NOS were detected by immunohistochemistry;CRP,ESR,PCT,D-dimerization of three groups of patients were recorded before treatment and after the 14 th day of treatment Body,CD68,Arg-1,CD163,i NOS and local wound symptom scores.The t test was used to compare the data differences of CRP,ESR,PCT,D-dimer,CD68,Arg-1,CD163,i NOS and local wound symptom score in each group,and multivariate analysis of variance was used for CRP,ESR in each group,PCT,D-dimer,CD68,Arg-1,CD163,i NOS and wound symptom scores.Result:1.The research results of serum CRP,ESR,PCT and plasma D-dimer showed that the contents of serum CRP,ESR,PCT and plasma D-dimer were all lower than those before treatment in the three groups after treatment(P<0.05).VSD Compared with the VSDNS group,the VSDOS group and the VSDOS group,the serum CRP,ESR,PCT and plasma D-dimer contents in the VSDOS group decreased most significantly after treatment(P<0.05),followed by the VSDNS group(P<0.05)..2.The research results of granulation tissue macrophage markers CD68,Arg-1,CD163 and i NOS showed that:(1)The expression of CD68 in the three groups after treatment was lower than that before treatment(P<0.05).The expression of CD68 in the VSDOS group decreased more significantly than before treatment(P<0.05),followed by the VSDNS group(P<0.05).(2)The expression levels of Arg-1 and CD163 in the three groups after treatment were higher than those before treatment(P<0.05),but compared with the three groups,the expression levels of Arg-1 and CD163 in the VSDOS group after treatment were higher than those before treatment.Significant(P<0.05),followed by VSDNS group(P<0.05).(3)The expression of i NOS in VSDNS group and VSDOS group after treatment was lower than that before treatment(P<0.05).3.The research results of wound symptom scores showed that the symptom scores of the three groups of patients after treatment were all lower than those before treatment(P<0.05),and the symptom scores of the VSDOS group after treatment were lower than those of the VSD group and the VSDNS group(P<0.05).The symptom score of VSDNS group was lower than that of VSD group after treatment(P<0.05),but the decrease was more significant in VSDOS group(P<0.05).Conclusion:1.VSDOS can significantly reduce the content of serum CRP,ESR,PCT and plasma D-dimer in patients with chronic wounds of diabetic foot,and its curative effect is the best.2.VSDOS can significantly reduce the expression of macrophage markers CD68 and i NOS in the granulation tissue of chronic diabetic foot wound,up-regulate the expression level of Arg-1 and CD163,reduce the excessive inflammatory response of chronic diabetic foot wound,and promote wound healing with the best curative effect.3.VSDOS can significantly relieve the symptoms and improve the prognosis of patients with chronic wounds of diabetic foot,and improve their quality of life.