| Objectives To observe and evaluate the therapeutic effect of negative pressure drainage combined with rh-aFGF and oxygen-containing liquid on Wagner grade 3 wounds of diabetic foot,and to find a new method to promote the rapid healing of Wagner grade 3wounds in diabetic foot.Methods Sixty patients with Wagner grade 3 diabetes mellitus were randomly divided into four groups(n = 15)according to the random number table.Sixty patients with Wagner grade 3 diabetes mellitus were randomly divided into four groups(n = 15)according to the random number table.There were no significant differences in age,sex,post-debridement area,wound formation time,duration of diabetes mellitus,ankle-brachial index,serum albumin and glycosylated hemoglobin in the four groups(P > 0.05).All patients were given control of blood sugar,improve the cycle,nutrition,nerves and other body support treatment,and in the improvement of the necessary tests,check the wound debridement.After debridement,negative pressure combined with physiological saline group(A group)with negative pressure drainage(-125 mm Hg,below)combined with saline irrigation treatment(drop 40 drops / minute,the same below)and the negative pressure drainage 48 h before continuing to attract,after absorbing 5 min and 2 min stop mode of intermittent negative pressure(below);negative pressure combined with rh-aFGF washing group(group B)with negative pressure drainage combined with rh-aFGF irrigation treatment(5 rh-aFGF dissolved in 1000 ml saline,the same below);negative pressure combined with washing liquid oxygen group(C group)with negative pressure drainage combined with liquid oxygen(the oxygen flow rate of 1 L/min,the same below)combined with rh-aFGF and negative pressure irrigation treatment;oxygen containing liquid washing group(D group)with negative pressure drainage combined with rh-aFGF and oxygen containing washing liquid treatment.After 5 days of continuous treatment,the negative pressure suction device was removed after 5 days.The fifth groups were compared before and after treatment for the control of inflammatory index,granulation tissue growth score,local tissue oxygen partial pressure and wound healing rate in the four groups.Results 1 Inflammatory index control: The rate of four groups in the treatment of peripheral white blood cell count,C-reactive protein and erythrocyte sedimentation,there were no significant differences(P values were greater than 0.05);the four groups were respectively after appropriate treatment,the inflammation was controlled in different degrees,compared with the above three indexes were decreased in varying degrees and in the fifth days after treatment between the four groups,the differences were statistically significant(P < 0.05).2 The growth of granulation tissue score: Scores of four groups respectively,the growth of granulation tissue(1.53 + 0.18),(1.50 + 0.27),(1.53 + 0.30),(1.53 + 0.33),comparison between groups,the difference was not statistically significant(P > 0.05);the four groups were respectively after the corresponding treatment,granulation tissues at different degree the growth and fifth days after treatment,scores of the four groups respectively.The growth of granulation tissue(1.93 + 0.35),(2.45 + 0.24),(2.49 +0.28),(3.17 + 0.43),comparison between groups,the difference was statistically significant(P < 0.05).The growth of granulation tissue of D group was higher than that of A group,B group and C group(P < 0.05);B group compared with C group,the difference was not statistically significant(P > 0.05),B group was higher than that of group A(P <0.05),C group was higher than that of group A(P < 0.05).3 Local tissue oxygen pressure: Treatment of local tissue oxygen pressure four groups were respectively(35.76 + 4.11),(36.63 + 5.79),(35.69 + 7.72),(35.47 + 5.15),comparison between groups,the difference was not statistically significant(P > 0.05);the four groups were respectively after the corresponding treatment,except the A group.Local tissue oxygen pressure is increased and fifth days after treatment,four groups of local wound tissue oxygen pressure respectively(35.69 + 4.46),(48.19 + 5.76),(62.23 + 4.21),(78.53 + 4.94),comparison between groups,the difference was statistically significant(P < 0.05).In group D,the partial pressure of oxygen was higher than that of A group,B group and C group(P value was less than 0.05),C group was higher than B group and A group(P value was less than 0.05),B group was higher than A group(P < 0.05).4 Wound healing rate: There was no significant difference in the area of wound healing after treatment in the first four groups(P > 0.05).The four groups were respectively after appropriate treatment,the wound area decreased and fifth days after treatment,four groups of wound healing rates were(5.04 + 1.56),(8.18 + 2.03),(9.90 + 2.42),(11.62 + 3.05),comparison between groups,the difference was statistically significant(P < 0.05).B group,C group and D group were higher than those of A group(P value was less than 0.05),C group was higher than B group(P < 0.05),D group was higher than B group(P < 0.05),D group was higher than C group(P < 0.05).Conclusions The treatment of diabetic foot wound Wagner3 negative pressure drainage combined with rh-aFGF and oxygen containing washing liquid,can control the wound inflammation effectively,stimulate the growth of granulation tissue,improve local wound tissue oxygen pressure and promote wound healing,can overcome the clinical application of single technology is not enough,and to achieve the purpose of three complementary technical advantages. |
PDF Full Text Request