Therapeutic effect of tibial periosteal distraction combined with platelet-rich plasma on diabetic foot ulcer
Objective To evaluate the clinical efficacy of tibial periosteal distraction combined with platelet-richplasma(PRP)in the treatment of diabetic foot ulcer.Methods From January 15,2022 to April 30,2023,a total of 26 diabetic foot patients with Wagner grade 2 to 4 received comprehensive basic treatment at the Department of Wound Repair and plastic Surgery the Hospital Affiliated to Shandong University of Traditional Chinese Medicine and Peking University Care Luzhony Hospital Burn and Wound Repair Center.They were divided into tibial periosteal stretch group(control group)and tibial periosteal stretch combined with PRP group(observation group)according to random number table,with 13 cases in each group.Tibial periosteal stretch group was treated with tibial periosteal distraction plus routine debridement and dressing change.Tibial periosteal stretch combined with PRP group was treated with tibial periosteal distraction and routine debridement and dressing change with PRP.The numerical oxygen saturation,foot temperature,ankle-brachial index,wound area,numerical rating scale(NRS)score and Bates-Jense wound assessment tool(BWAT),diabetes-Specific quality of life scale(DSQL)score of the two groups were recorded before treatment and 1,2,4,and 6 weeks after treatment and wound healing rate at 6 weeks after treatment,computed tomogrophy angiography(CTA)assessment of blood flow of affected limb,clinical efficacy and adverse reactions during treatment were also recorded.The clinical efficacy of the two groups of patients was evaluated.Results After treatment,oxygen saturation,foot temperature,ankle-brachial index wound area,NRS score,BWAT score and DSQL score of both groups were improved compared with those before treatment(P＜0.05).The wound volume,NRS score,BWAT score and DSQL score of tibial periosteal stretch combined with PRP group were significantly lower than those of tibial periosteal stretch group at each time point after treatment(P＜0.05).Follow-up to 6 weeks after treatment,CTA of lower limbs in both showed the formation of small blood vessels and collateral circulation in the stretch area of lower limbs,and some blood vessels extended to the distal end,with no significant difference between the two groups(P＞0.05).The wound healing rate and clinical efficacy of tibial periosteal stretch combined with PRP group were better than those of tibial periosteal stretch group(P＜0.05).There were no serious adverse reactions in both groups.Conclusion Tibial periosteal distraction combined with platelet-rich plasma(PRP)therapy can better promote the healing of diabetic foot ulcer,relieve pain and improve the quality of life of patients.
Platelet-rich plasmaDiabetic footUlcerTibial periosteal distractionComparative effectiveness research
万方数据
维普
