Application of transverse tibial bone transport microangiogenesis combined with vacuum drainage in the treatment of diabetic foot ulcer / 中国医师进修杂志

ABSTRACT

Objective:To explore the application of transverse tibial bone transport microangiogenesis combined with vacuum drainage in the treatment of diabetic foot ulcer.Methods:During April 2018 to April 2019, the clinical data of 87 patients with diabetic foot ulcer who were performed transverse tibial bone transport microangiogenesis combined with vacuum drainage in Changxing County Hospital of Traditional Chinese Medicine of Zhejiang Province were collected. In this study, there were 64 cases of males and 23 cases of females, aged 43-84 years, and average age was (64.5 ± 8.4) years. Right foots of 42 cases and left foots of 45 cases received operation. The diabetic course was (13.7 ± 6.2) years. The area of ulcer was 2.2 cm × 3.0 cm-7.5 cm × 5.7 cm. According Wagner grade, 16 case was Ⅱ garde, 38 cases was Ⅲ grade, 30 cases was Ⅳ grade, and 3 cases was Ⅴ grade. All patients were given treatment of anti-infection, monitoring of blood glucose and correcting hypoproteinemia. Ankle-brachial index(ABI) and Michigan Neuropathy Screening Instrument (MNSI) score were used to evaluate the recovery of peripheral vessel and nerve before operation and 3 months after operation. All patients were evaluated by angiography or color Doppler ultrasound after operation.Results:All patients were followed up for 3-24 months with average 13.6 months, and the wound surface were healed. At 3 months after operation, the ABI increased from 0.59 ± 0.19 to 0.89 ± 0.28, the scores of MNSI decreased from (5.81 ± 1.60) scores to (4.42 ± 1.25) scores, and there were significant differences ( P<0.05). The postoperative angiography and vascular ultrasound of 74 cases showed satisfied regeneration of micro-vessel. Conclusions:Transverse tibial bone transport microangiogenesis combined with vacuum drainage can rebuild the micro-vessel in the treatment of diabetic foot ulcer, and improve the wound surface healing. It is an effective method in treatment of diabetic foot ulcer.