Clinical efficacy of VSD combined with silver-containing liquid dressing in the treatment of diabetic foot
Objective:To study the clinical efficacy of vaccum sealing drainage(VSD)combined with silver-containing liquid dressing in the treatment of diabetic foot.Methods:Sixty-four patients with diabetic foot(Wagner grade 2-4)admitted to the Department of Burns and Plastic Surgery,the 910th Hospital of Joint Service Support Force of PLA from September 2020 to September 2021.They were divided into observation group and control group.The observation group was randomly selected from single day patients,and the control group was randomly selected from double day patients,with 32 cases in each group.The observation group was treated with wound debridement and VSD.The surgical area was rinsed with 0.9%sodium chloride solution regularly.Silver-containing liquid dressing was injected into the wound through the VSD side hole every day.The wound was soaked for 10 to15 min,then the drainage tube was opened to suck out the silver-containing liquid dressing for 7 days.The treatment of the control group was the same as that of the observation group except that no silver-containing dressing was used.The VSD was removed 7 days after operation,and the wound granulation tissue coverage rate,wound bacterial clearance rate and granulation tissue morphology of the two groups were compared.Three weeks after secondary skin grafting,the survival rate and amputation rate of skin grafts in two groups were observed.Results:Seven days after VSD debridement,the granulation tissue coverage rate and wound bacterial clearance rate in the observation group were(94.02±2.41)%and(91.79±2.01)%,respectively,higher than those in the control group(85.95±2.52)%and(75.15±2.28)%,with statistical significance(P＜0.001).Granulation tissue morphology of observation group(1.12±0.09)was better than that of control group(1.61±0.14),with statistical significance(P＜0.001).Three weeks after the second stage skin grafting,the survival rate of skin graft in the observation group(96.47±1.60)%,higher than in the control group(81.75±3.79)%,(P＜0.001).The amputation rate in the observation group was 0,which was lower than the control group(6.25%),but the difference was not significant(P＞0.05).Conclusions:VSD combined with silver-containing liquid dressing is effective in treating diabetic foot,which can ensure good growth of fresh granulation,good antibacterial effect and high survival rate of autologous skin tablets,which deserves further promotion in clinical practice.
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