皮缘缝合联合负压引流技术对糖尿病足截趾术后创面愈合效果的影响  

Effect of Skin Edge Suture Combined with Vacuum Sealing Drainage on Wound Healingof Diabetic Foot after Toe Amputation

作　　者：韩李念 王君[1] 倪子樵 HAN Linian;WANG Jun;NI Ziqiao(Department of Burns and Plastic Surgery,the First Afiliated Hospital of Anhui University of Science and Technology,Huainan 232000,Anhui,China)

机构地区：[1]安徽理工大学第一附属医院烧伤整形科,安徽淮南232000

出　　处：《中国美容医学》2025年第1期62-65,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究糖尿病足坏疽(Diabetic foot gangrene,DFG)截趾术后创面皮缘缝合联合负压引流技术(Vacuum sealing drainage,VSD)对患者创面愈合进程及愈合效果的影响。方法:选取2019年8月-2023年2月笔者医院收治的90例糖尿病足坏疽患者,按照随机数字表法分为对照组和观察组,各45例。对照组截趾术后采用创面皮缘缝合术,观察组在对照组基础上联合VSD治疗。统计比较两组临床疗效、术后恢复相关指标、瘢痕[温哥华瘢痕量表(VSS)]及血清炎性指标[超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)]水平。结果:治疗后,观察组临床总有效率为95.56%,高于对照组的82.22%(P<0.05);观察组换药次数少于对照组,创面愈合时间及住院时间均短于对照组(P<0.05);术后7 d,两组血清hs-CRP、PCT水平较治疗前均降低,且观察组低于对照组(P<0.05);术后14 d,观察组创面细菌转阴率为97.78%,高于对照组60.00%(P<0.05);术后3个月,两组瘢痕状态评分较治疗28 d时均降低,且观察组低于对照组(P<0.05)。结论:采用创面皮缘缝合联合VSD治疗,能有效控制DFG截趾术后患者创面感染,进而抑制炎性因子表达,促进创面愈合及瘢痕修复。Objective observe the influence of wound skin edge suture combined with vacuum sealing drainage(VSD)on the wound healing process and healing effect in patients with diabetic foot gangrene(DFG)after toe amputation.Methods A total of 90 patients with diabetic foot gangrene admitted to the author's hospital from August 2019 to February 2023 were selected and divided into a control group and an observation group according to the random number table method,with 45 cases in each group.The control group was treated with wound edge suture after toe amputation,and the observation group was treated with VSD on the basis of the control group.The clinical efficacy,postoperative recovery related indicators,scar[Vancouver Scar scale(VSS)]and serum inflammatory indicators[high-sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT)]J levels were compared between the two groups.Results After treatment,the total effective rate of the observation group was 95.56%,which was higher than 82.22%of the control group(P<0.05).The frequency of dressing change in the observation group was less than that in the control group,and the wound healing time and hospitalization time were shorter than those in the control group(P<0.05).Seven days after surgery,the levels of serum hs-CRP and PCT in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).14 days after surgery,the negative conversion rate of wound bacteria in the observation group was 97.78%,which was higher than 60.00%in the control group(P<0.05).Three months after surgery,the scores of scar status in the two groups were lower than those on 28 days of treatment,and those in the observation group were lower than the control group(P<0.05).Conclusion The combination of wound skin edge suture and VSD can effectively control the wound infection of patients after DFG toe amputation,inhibit the expressions of inflammatory factors,and promote the wound healing and scar repair.

关 键 词：糖尿病足坏疽 截趾术 皮缘缝合 负压引流技术 创面愈合 

分 类 号：R622[医药卫生—整形外科]