The Efficacy of Nano-Silver Alginate Dressing Combined with Tibial Transverse Transport for Stage III–IV Diabetic Foot Treatment

Abstract

To effectively treat severe diabetic foot (DF) and reduce amputation risk, we explored nano-silver alginate (Ag/Alg) dressings and tibial transverse transport (TTT) to improve circulation and suppress inflammatory responses in lower limbs. First, Ag/Alg dressings were biocompatible without affecting L-929 cell activity, and they had better hygroscopic properties when compared with conventional dressings. Ag/Alg dressing also markedly inhibited Gram+/Gram− bacterial activity. We also retrospectively analyzed clinical data from DF patients at our hospital and divided them into control and TTT groups according to treatment modality; the latter group was treated with TTT and Ag/Alg dressings as conventional therapy. We then compared cytokines, inflammatory responses, blood supply to the foot, and ulcer healing characteristics between pre- and post-treatments. TTT patients displayed significantly higher angiogenesis-related cytokine levels and more effective inflammation control after treatment when compared with patients receiving conventional therapy. Additionally, more significant increases in ankle-brachial index and skin temperature, and a greater decrease in the visual analog scale were observed in TTT patients. In terms of surface ulcer healing, TTT patients showed better healing, with healing times, amputation rates, and ulcer recurrence rates significantly reduced. Therefore, Ag/Alg dressings combined with TTT showed great potential for severe DF therapy.