Clinical Study Of Vacuum Sealing Drainage Combined With Hyperoxia Solution On Diabetic Chronic Wounds In High Altitude Area

Objective: To investigate the clinical efficacy of vacuum sealing drainage combined with hyperoxia solution in the treatment of diabetic chronic wounds at high altitude localities.Methods: 45 patients with diabetic chronic wound who were hospitalized from September 2017 to October 2019 were selected to participate in the experiment.The patients were divided into VSD group,VSDN group and VSDO group according to the method of random number table,with 15 cases in each group.All patients underwent debridement after hospitalization,at the same time,give diabetes diet,blood sugar control and anti infection treatment.VSD group was treated with VSD alone.The VSDN group was treated with VSD combined with normal saline irrigation.The VSDO group was treated with VSD and hyperoxia solution.VSD negative pressure value is set to-100?-80 mm Hg,50 drops / minute for irrigation treatment.The peripheral venous blood of patients was drawn to test the level of leukocyte and C-reactive protein before treatment and on the 7th day of treatment.HE staining of granulation tissue from the center of wound.Detection of VEGF and b FGF expression in granulation tissue by immunohistochemistry.Read the number of microvessels after CD31 staining of granulation tissue.Take secretion from wound for bacterial culture.Calculate bacterial clearance and wound granulation tissue coverage.Results: There was no significant difference in general data,blood related indexes and pathological observation indexes among the three groups before treatment(P<0.05).7 days after treatment:(1)The leukocyte count and C-reactive protein of the three groups were lower than before.VSDO group was lower than VSDN group and VSD group,the difference was statistically significant(P<0.05).(2)HE staining showed that the granulation tissue of VSDO group was better than that of VSDN group and VSD group.(3)After CD31 staining,the number of blood vessels in VSDO group was higher than that in VSDN group and VSD group,the difference was statistically significant(P<0.05).(4)It was obvious that average optical density of VEGF and b FGF in the three groups was higher than that before treatment,and the VSDO group was higher than that in the VSDN group and VSD group,the difference was statistically.(5)The granulation tissue coverage rate and bacterial clearance rate of VSDO group were higher than those of the other two groups,the difference was statistically significant(P<0.05).Conclusion: VSD combined with hyperoxic solution lavage in the treatment of diabetic chronic wounds can more effectively remove the bacteria and reduce the inflammation of the wounds.Promote the synthesis of VEGF and b FGF,promote the angiogenesis of granulation tissue,and improve the granulation tissue coverage ratio on the wound surface.