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。

IF 1.3 Q3 SURGERY
Archives of Plastic Surgery-APS Pub Date : 2025-05-15 eCollection Date: 2025-05-01 DOI:10.1055/a-2544-2938
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
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引用次数: 0

摘要

糖尿病足溃疡(DFUs)影响了大约20%的糖尿病患者,并具有显著的风险,特别是足底伤口承受重量。常规治疗往往效果不佳,因此有必要探索重建方案。整形手术干预,如皮肤移植和皮瓣,已经显示出有希望的结果,但有相当大的并发症。本研究评估旋转皮瓣重建与切口负压创面治疗(NPWT)治疗足底dfu的疗效。方法对42例行旋转皮瓣闭合治疗足底DFUs的患者进行回顾性分析。我们通过积极的感染控制和血管评估来优化术前条件。我们以切口NPWT为手术技术进行旋转皮瓣。我们通过卸载连续切口NPWT和穿鞋来处理术后情况。结果所有患者均实现创面初步愈合,平均持续时间36天。14%的病例出现并发症。随访期间复发率为21%,其中Charcot足畸形患者复发率明显高于其他患者。我们提出三个例子来证明旋转皮瓣的有效性。结论旋转皮瓣闭合加切口NPWT是治疗足底DFUs的可行方法,具有初始愈合率高、并发症少、复发率低的优点。值得注意的是,Charcot足畸形患者需要更多的关注和干预,以防止复发。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

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来源期刊
CiteScore
2.10
自引率
6.70%
发文量
131
审稿时长
10 weeks
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