Jiajun Feng, Coeway Boulder Thng, Jason Wong, Quah Mei Fern Alison, Nicole Tao Ying Lim, Francis Keng Lin Wong, Kimberley Leow, Leon Timothy Charles Alvis, Sum Leong, Farah Gillan Irani, Wenxian Png, Eric Wei Liang Cher, Yee Onn Kok, Allen Wei-Jiat Wong, Khong Yik Chew
{"title":"旋转皮瓣联合切口负压创面治疗足底糖尿病足溃疡的疗效。","authors":"Jiajun Feng, Coeway Boulder Thng, Jason Wong, Quah Mei Fern Alison, Nicole Tao Ying Lim, Francis Keng Lin Wong, Kimberley Leow, Leon Timothy Charles Alvis, Sum Leong, Farah Gillan Irani, Wenxian Png, Eric Wei Liang Cher, Yee Onn Kok, Allen Wei-Jiat Wong, Khong Yik Chew","doi":"10.1055/a-2544-2938","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background</b> Diabetic foot ulcers (DFUs) affect approximately 20% of diabetic patients and pose significant risks, especially for plantar wounds that bear weight. Conventional treatments often have suboptimal results, necessitating the exploration of reconstructive options. Plastic surgery interventions, such as skin grafts and flaps, have shown promising outcomes, but with considerable complications. This study evaluates the efficacy of rotation flap reconstruction with incisional negative pressure wound therapy (NPWT) for plantar DFUs. <b>Methods</b> We conducted a retrospective review of 42 patients who underwent rotation flap closure for plantar DFUs. We optimized the preoperative conditions with aggressive infection control and vascular assessment. We performed rotation flaps with incisional NPWT as the operative technique. We managed the postoperative conditions with offloading continuous incisional NPWT and footwear. <b>Results</b> All patients achieved initial wound healing, with a median duration of 36 days. Complications occurred in 14% of cases. The recurrence rate was 21% during follow-up, which was significantly higher in patients with Charcot foot deformity. We present three illustrative cases that demonstrate the efficacy of rotation flaps. <b>Conclusion</b> Rotation flap closure, supplemented by incisional NPWT, emerges as a viable option for plantar DFUs, achieving high initial healing rates, low complications, and reduced recurrence. Notably, patients with Charcot foot deformity require more attention and intervention to prevent recurrence.</p>","PeriodicalId":47543,"journal":{"name":"Archives of Plastic Surgery-APS","volume":"52 3","pages":"169-177"},"PeriodicalIF":1.3000,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081091/pdf/","citationCount":"0","resultStr":"{\"title\":\"Outcome of Rotation Flap Combined with Incisional Negative Pressure Wound Therapy for Plantar Diabetic Foot Ulcers.\",\"authors\":\"Jiajun Feng, Coeway Boulder Thng, Jason Wong, Quah Mei Fern Alison, Nicole Tao Ying Lim, Francis Keng Lin Wong, Kimberley Leow, Leon Timothy Charles Alvis, Sum Leong, Farah Gillan Irani, Wenxian Png, Eric Wei Liang Cher, Yee Onn Kok, Allen Wei-Jiat Wong, Khong Yik Chew\",\"doi\":\"10.1055/a-2544-2938\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background</b> Diabetic foot ulcers (DFUs) affect approximately 20% of diabetic patients and pose significant risks, especially for plantar wounds that bear weight. Conventional treatments often have suboptimal results, necessitating the exploration of reconstructive options. Plastic surgery interventions, such as skin grafts and flaps, have shown promising outcomes, but with considerable complications. This study evaluates the efficacy of rotation flap reconstruction with incisional negative pressure wound therapy (NPWT) for plantar DFUs. <b>Methods</b> We conducted a retrospective review of 42 patients who underwent rotation flap closure for plantar DFUs. We optimized the preoperative conditions with aggressive infection control and vascular assessment. We performed rotation flaps with incisional NPWT as the operative technique. We managed the postoperative conditions with offloading continuous incisional NPWT and footwear. <b>Results</b> All patients achieved initial wound healing, with a median duration of 36 days. Complications occurred in 14% of cases. The recurrence rate was 21% during follow-up, which was significantly higher in patients with Charcot foot deformity. We present three illustrative cases that demonstrate the efficacy of rotation flaps. <b>Conclusion</b> Rotation flap closure, supplemented by incisional NPWT, emerges as a viable option for plantar DFUs, achieving high initial healing rates, low complications, and reduced recurrence. Notably, patients with Charcot foot deformity require more attention and intervention to prevent recurrence.</p>\",\"PeriodicalId\":47543,\"journal\":{\"name\":\"Archives of Plastic Surgery-APS\",\"volume\":\"52 3\",\"pages\":\"169-177\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-05-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081091/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Plastic Surgery-APS\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2544-2938\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Plastic Surgery-APS","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/a-2544-2938","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Outcome of Rotation Flap Combined with Incisional Negative Pressure Wound Therapy for Plantar Diabetic Foot Ulcers.
Background Diabetic foot ulcers (DFUs) affect approximately 20% of diabetic patients and pose significant risks, especially for plantar wounds that bear weight. Conventional treatments often have suboptimal results, necessitating the exploration of reconstructive options. Plastic surgery interventions, such as skin grafts and flaps, have shown promising outcomes, but with considerable complications. This study evaluates the efficacy of rotation flap reconstruction with incisional negative pressure wound therapy (NPWT) for plantar DFUs. Methods We conducted a retrospective review of 42 patients who underwent rotation flap closure for plantar DFUs. We optimized the preoperative conditions with aggressive infection control and vascular assessment. We performed rotation flaps with incisional NPWT as the operative technique. We managed the postoperative conditions with offloading continuous incisional NPWT and footwear. Results All patients achieved initial wound healing, with a median duration of 36 days. Complications occurred in 14% of cases. The recurrence rate was 21% during follow-up, which was significantly higher in patients with Charcot foot deformity. We present three illustrative cases that demonstrate the efficacy of rotation flaps. Conclusion Rotation flap closure, supplemented by incisional NPWT, emerges as a viable option for plantar DFUs, achieving high initial healing rates, low complications, and reduced recurrence. Notably, patients with Charcot foot deformity require more attention and intervention to prevent recurrence.