Effects of antibiotic-loaded bone cement coverage versus negative pressure wound therapy on diabetic foot ulcer wound healing
Objective To compare the effects of antibiotic-loaded bone cement coverage and neg-ative pressure wound therapy(NPWT)on diabetic foot ulcer wound healing.Methods A total of 113 patients with diabetic foot ulcers were selected as study subjects and randomly divided into control group(57 patients receiving NPWT)and experimental group(56 patients receiving antibiotic-loaded bone cement coverage)using the double-color ball randomization method.Both groups underwent rou-tine debridement.The treatment outcomes,positive detection rate of wound bacterial culture,lower limb nerve conduction function(tibial nerve motor conduction velocity,common peroneal nerve senso-ry conduction velocity),Doppler ultrasound indicators(vessel diameter,blood flow velocity,resist-ance index,pulsatility index),inflammatory indicators(tumor necrosis factor-α,interleukin-6,high-sensitivity C-reactive protein),and granulation tissue growth were observed and compared between the two groups.Results The effective treatment rate was 85.71％in the experimental group,which was higher than 70.18％in the control group(P＜0.05).Before treatment,there were no statistically sig-nificant differences between the two groups in terms of positive detection rate of wound bacterial culture,tibial nerve motor conduction velocity,common peroneal nerve sensory conduction velocity,blood flow velocity,vessel diameter,resistance index,pulsatility index,granulation tissue growth,and serum levels of tumor necrosis factor-α,interleukin-6,and high-sensitivity C-reactive protein(P＞0.05).After 3,7,and 15 days of treatment,the positive detection rate of wound bacterial culture in the ex-perimental group was lower than that in the control group(P＜0.05).After treatment,the tibial nerve motor conduction velocity,common peroneal nerve sensory conduction velocity,vessel diame-ter,blood flow velocity,resistance index,and pulsatility index in both groups were higher or greater than those before treatment,and those in the experimental group were higher or greater than those in the control group(P＜0.05).After treatment,the granulation tissue area,coverage rate,and granulation tissue growth rate in the experimental group were higher than those in the control group(P＜0.05).After treatment,the serum levels of tumor necrosis factor-α,interleukin-6,and high-sensitivity C-reactive protein in both groups were lower than those before treatment,and those in the experimental group were lower than those in the control group(P＜0.05).Conclusion Compared with NPWT,antibiotic-loaded bone cement coverage has a higher effective treatment rate for diabetic foot ulcers,and provides a more effective local antibacterial environment,thereby promoting wound healing and tissue repair,and simultaneously improving nerve function and vascular status.
antibiotic-loaded bone cementnegative pressure wound therapydiabetic foot ulcerwound healinggranulation tissue
万方数据
维普
