ABSTRACT
Objective To investigate the clinical effects and indications of the vacuum sealing drainage (VSD) in the treatment of severe diabetic foot gangrene.Methods We randomly recruited 60 cases,who had suffered from diabetic foot gangrene(DFG) at the grade of 3 -5,according to Wagner scale into VSD treatment groups and treated them with VSD methods.At the same time,62 DFG cases who had given routine drainage treatment one year ago were retrospectively analyzed as control group.The observed items included the wound healing time,number of dressing,outcome of treatment ( healing rate),the average days in hospital,total expenses of hospitalization and so on.Results The wound healing time of VSD treatment group and routine treatment group were ( 30.5 ± 6.8 ) days and ( 53.8 ± 5.5 ) days,respectively ( t =2.636,P ＜ 0.01 ).The numbers of dressing were( 15.0 ± 4.7) days and ( 29.5 ± 6.1 ) days,respectively ( t =2.374,P ＜ 0.01 ).The healing rates were 96.7％ (58/60) and 87.1％ (54/62),respectively(P ＜0.01 ).The average period in hospitalization were (20.1 ± 3.5 ) days and ( 36.5 ± 4.6 ) days,respectively ( t =2.564,P ＜ 0.01 ).Total expenses of hospitalization were(20 155.6 ± 153.8) yuan RMB and(41 465.5 ± 146.6) yuan RMB,respectively(t =2.873,P ＜0.01 ).All the differences were statistically significant.Conclusion The VSD method is effective for the treatment of severe diabetic foot gangrene(DFG).It is able to reduce the time of wound healing significantly,increase the healing rate,shorten the hospitalization period and cut the general expenses during hospitalization.It' s an effective method for the treatment of DFG.
ABSTRACT
PURPOSE: To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) below the knee as a treatment in diabetic foot gangrene. MATERIALS AND METHODS: Between May 2003 and May 2006, angiography was performed in 35 diabetic foot gangrene classified as either Wagner grade IV or V. Infrapopliteal PTA was performed in 10 patients among them. Clinical success was defined as prevention of major amputation. RESULTS: Among 25 patients who did not receive infrapopliteal PTA, the major amputation rate is 22% (in one arterial occlusion cases), 50% (in two arterial occlusion cases), 63% (in three arterial occlusion cases), respectively. Infrapopliteal PTA was successfully performed in 8 among 10 patients. Two patients were failed and undergone below-knee amputation. Toe amputation were performed in 2 patients with one arterial occlusion. Out of 6 patients with three arterial occlusions, toe amputations were performed in 4 patients and the other 2 patients were healed through debridement. CONCLUSION: As a first choice revascularization procedure for limb salvage in diabetic foot gangrene, infrapopliteal PTA can be one of treatment options.