Clinical efficacy of endovascular revascularization combined with vacuum-assisted closure for the treatment of diabetic foot  

作　　者：Feng-Rui Lei Xiao-Fei Shen Chuang Zhang Xin-Qing Li Hao Zhuang Hong-Fei Sang 

机构地区：[1]Department of Vascular Surgery,The Second Affiliated Hospital of Soochow University,Suzhou 215004,Jiangsu Province,China

出　　处：《World Journal of Diabetes》2024年第7期1499-1508,共10页世界糖尿病杂志（英文版）（电子版）

摘　　要：BACKGROUND The diabetic foot is a common cause of disability and death,and comorbid foot infections usually lead to prolonged hospitalization,high healthcare costs,and a significant increase in amputation rates.And most diabetic foot trauma is complicated by lower extremity arteriopathy,which becomes an independent risk factor for major amputation in diabetic foot patients.AIM To establish the efficacy and safety of endovascular revascularization(ER)combined with vacuum-assisted closure(VAC)for the treatment of diabetic foot.METHODS Clinical data were collected from 40 patients with diabetic foot admitted to the Second Affiliated Hospital of Soochow University from April 2018 to April 2022.Diabetic foot lesions were graded according to Wagner’s classification,and blood flow to the lower extremity was evaluated using the ankle-brachial index test and computerized tomography angiography of the lower extremity arteries.Continuous subcutaneous insulin infusion pumps were used to achieve glycemic control.Lower limb revascularization was facilitated by percutaneous transluminal balloon angioplasty(BA)or stenting.Wounds were cleaned by nibbling debridement.Wound granulation tissue growth was induced by VAC,and wound repair was performed by skin grafting or skin flap transplantation.RESULTS Of the 35 cases treated with lower limb revascularization,34 were successful with a revascularization success rate of 97%.Of these,6 cases underwent stenting after BA of the superficial femoral artery,and 1 received popliteal artery stent implantation.In the 25 cases treated with infrapopliteal artery revascularization,39 arteries were reconstructed,7 of which were treated by drug-coated BA and the remaining 32 with plain old BA.VAC was performed in 32 wounds.Twenty-four cases of skin grafting and 2 cases of skin flap transplantation were performed.Two patients underwent major amputations,whereas 17 had minor amputations,accounting for a success limb salvage rate of 95%.CONCLUSION ER in combination with VAC is a safe and effective t

关 键 词：Diabetic foot REVASCULARIZATION Vacuum-assisted closure Balloon angioplasty Wound repair 

分 类 号：R587.1[医药卫生—内分泌]