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Objective To explore the repair method for refractory diabetic wound. Methods A total of 206 patients with refractory diabetic foot ulcers were treated with proper surgical treatments.Results Of all, 106 patients were treated by skin flap (51.5 % ), with one stage wound healing rate of 85.8%; 122 patients were repaired with split-thickness skin graft ( 59.2% ), with survival rate of the graft for 79.5%. Simple toe amputation was made in 34 patients (46 toes). The high level amputation was performed in 56 patients (27.2%). Of all, 132 patients were followed up for 6-18 months, which showed that ulcer recurred in 12 patients (9.1%). Conclusion Timely and effective treatment as well as flap and skin graft repair could reduce high level amputation rate of diabetic foot ulcer and promote the quality of life.
RESUMO
<p><b>OBJECTIVE</b>To study the effect of the color doppler flow imaging (CDFI) technique in the design of the axial pattern flap.</p><p><b>METHODS</b>From March 1996 to June 1999, ten patients were included in this study. Among them, there were seven males and three females. Their defects ranged from 6 cm x 8 cm to 15 cm x 20 cm. Before operation, an axial flap was designed by the traditional method. Then CDFI technique of high frequency (5.0-7.5 MHz) was used to examine the major arterial supply of the flap and modify the design accordingly. At last, the modified flap was transferred to cover the defect.</p><p><b>RESULTS</b>All the patients except one underwent the operation successfully. The cosmetic and functional results of the flap were excellent.</p><p><b>CONCLUSION</b>CDFI is a simple, direct and accurate method for detecting the vascular supply of an axial pattern flap. This technique should be popularized to avoid blindness of flap design.</p>