The Closed Negative Pressure Drainage Technology Of Treatment Of Diabetic Foot Wagner3 Curative Effect Observation Of Wounds

Purpose:To observe the clinical therapeutic effect of vacuum sealing drainage combined with oxygen therapy for Wagner3 grade of diabetic foot ulcer, to explore the effective method for the treatment of diabetic foot.Methods:This study from 2011 March to 2014 March in our hospital 66 cases of diabetic foot patients in Department of Endocrinology and Department of orthopedics in hospital. Patients in treatment group in which 36 cases, male 24 cases, female 12 cases, age 48-70 years old, the average age of (59.6+2.8). The wound area ranging from 1.0cm* 1.6cm-5.1cm* 8.6cm.30 cases of control group patients, male 17 cases, female 13 cases, age 46-75 years old, average 57.2+3.1 years. The wound area ranging from 1.2cm* 0.8cm-4.0cm* 8.1cm. The selected objects are in line with the diabetic diagnostic standard of WHO in 1999, diabetes duration 5-12 years (mean 7 years), the average HbAlc8.3%, foot ulcer of diabetes foot clinical guidelines in accordance with the "international" Wagner classification:meet Wagner3 level. The 2 groups were given conventional therapy, and actively take effective measures to control blood sugar in diabetes diet, based on moderately enhanced dietary nutrition, take the gas ring, cotton pad tools such as support, reduce local and oppressive surrounding the wound; if the wound infection, then take secretion or pus for bacterial culture and drug sensitive test routine choose sensitive antibiotic, active anti infection treatment, the control group in the conventional treatment on the basis of, using the traditional dressing for wound, and according to the surrounding the wound exudation and local blood circulation state adjust dressing change frequency, dressing interval time general for 7 days before the daily change medicine 1 times, eighth days later to every 1-3 days change medicine 1 times, have been changed to wound healing so far. The treatment group on the basis of conventional therapy, given the vacuum sealing drainage combined with oxygen, according to the size of wound cut or splicing of vacuum sealing drainage device (VSD, by Weiss of Wuhan the company), the use of biological semipermeable membrane sealed drainage area also makes the wound cut off from the outside world. Connected with a negative pressure source and an oxygen source, the formation of a one-way, closed drainage and wound and efficient support system. The two groups were observed for 30 days and 30 days of treatment both before and after the observation of blood rheology and fluid mechanics index dorsal artery, and keep the follow-up for 6 months to a year.Results:All patients were effectively control blood glucose, body temperature, blood routine examination was normal, and no local sinus, no pain, infection was controlled effectively. Patients were followed up for 4 months to one year, no recurrence of infection. Satisfactory outcomes were combined with oxygen therapy or conventional treatment by the 2 groups of patients after negative pressure drainage. Among them, the negative pressure drainage combined with oxygen therapeutic group (the total efficiency of 94%) is obviously superior to the conventional therapy group (the total efficiency of 83%). And the patients in the treatment group were cured, markedly effective, improved time were significantly shorter than that in the control group, the difference was statistically significant (P<0.05). Compared with the control group, the treatment of patients with skin grafting or flap transfer group at the time, the frequency of dressing change, the overall cost of treatment has significant difference (P<0.05).Before and after treatment in two groups of indexes of blood rheology and the dorsalis pedis artery hemodynamics indexes were improved, the treatment group was significantly better than the control group.Conclusions:VSD combined with oxygen therapy has a good effect on diabetic foot ulcer wound repair level Wagner3, can effectively promote the healing of wound, its effect was better than that of traditional methods, and can lay a good foundation for skin grafting or flap transfer success. In addition, the method also has the technology is simple, easy to master the advantage. Therefore, suitable for popularization and application in the clinical treatment of diabetic foot.