Retrospective Analysis Of Treatment For Diabetic Foot Ulcers (Wagner 2-3 Grade)with Vacuum Sealing Drainage

Objective:Retrospective analysis of the clinical curative effect of vacuum sealing drainage for the treatment of diabetic foot(DF) ulcers(Wagner 2-3 grade).Methods: 1. Research subjectTo review the patients with diabetic foot, the Department of hospitalized patients with burn department of Tianjin First Central Hospital from January 2012 to December 2014.2. Accepting criteria(1) The discharged patients had been confirmed, treated with surgery in stable condition.(2) without any other types of vascular lesions, skin lesions.(3)During hospitalization,diabetic foot ulcers is the primary symptom of patients, and the disease tends to stabilize, without end-stage renal disease.(4) During hospitalization patients had good compliance, and did not give up treatment or discharged automatically.(5) DF ulcers is estimated to Wagner 2-3 grade.3. Group of study subject120 patients with diabetic foot is in total,including 42 male cases, 78 female cases. Age: 55 ~ 78 years old, average(64.4 ± 5.1). Duration of diabetes: 1 ~ 16 years, average(7.4 ± 2.2) years. DF ulcers duration:8 ~ 194 d,average(81 ± 40) d. Ulcer area: 3 cm × 4 cm ~10 cm × 10 cm.According to application of VSD or not, the patients were divided intoexperimental group and control group. Experimental group: 60 patients, including 18 male cases, 42 female cases. Age: 55 ~ 74 years old, average(65.1 ± 5.5). Average of duration of diabetes:(7.5 ± 2.2) years. Average of DF ulcers duration:(83 ± 40) d. Control group: 60 patients, including 24 male cases, 36 female cases. Age: 60 ~ 78 years old, average(63.8± 4.6). Average of duration of diabetes:(7.4 ± 2.3) years. Average of DF ulcers duration:(80 ± 40) d.4. Treatments Experimental group: Vacuum sealing drainage is carried on after surgical debridement and the negative pressure is maintained 80 mm Hg~125mm Hg. After treatment, 500 m L 0.9% salt water washing drainage for 3 to5 days,treatment of VSD lasted 7 to 10 days, then replacing the VSD dressings or skin-grafting according to the growth of granulation and wound infection.Control group: Given conventional treatment processing after surgical debridement. Covered with the sterile gauze and Changing the bandage once a day. According to the growth of granulation situation, the post-processing was carried or not.The other treatments: Glucose controlling,complication controlling,antiinfecation,minicirculation improving and surgical debridement are given to the two groups of patients.5. Observing indicators According to discharge and follow up record, statistics of two groups of patients with average frequency of dressing change,average healing time of the wounds, pain level or satisfaction during hospitalization. According to the questionnaire, the satisfaction of patients was statistically.6. Statistical methods The data obtained are processed with SPSS19.0.Measurement data is expression with(`x±s). Comparison between group by the t test, analysis of attribute data bythe x2 test. and it showed statistically significant difference when P ﹤0.05.Results:(1) Experimental group: after treatment of VSD, granulation tissue wound could treat with skin-grafting. Compared with control group, the dressing change times of the experimental group was 5.8±0.9, which lower than that of the control group(31.6±3.3). The difference was statistically significant(P< 0.05).(2) During hospitalization,the experimental group was treated with VSD, the average healing time of wound was 28.9±5.6 d, which lower than that of the control group(50.6±5.4) d. The difference was statistically significant(P< 0.05).(3) Compared with control group, the pain of the patients was significantly relieved, and the pain peak was scored by the visual analogue scale score was 4.3±2.0,which lower than that of the control group(6.8 ± 1.7). The difference was statistically significant(P< 0.05).(4) Satisfaction score of experimental group was 88.6±6.5 and the score of the control group was69.2±10.6. The difference was statistically significant(P< 0.05).Conclusion: VSD treatment of diabetic foot ulcers(Wagner2~3 grade) had a better curative effect and help to reduce the frequency of traditional dressing change, save the manpower, accelerate wound healing and relieve the pain of patients. The results showed the VSD treatment was worth to popularize and apply in the treatment of diabetic foot. The expensive price will limit its application in clinic widely.