Analysis of factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa

Abstract

Objective To investigate the factors related to healing of severe diabetic foot gangrene (Wagner 4 class above) infected with pan-resistant Pseudomonas aeruginosa, and to guide clinical treatment. Methods Forty-nine hospitalized patients with diabetic foot gangrene (Wagner 4 class above) from January 2009 to July 2014 were enrolled. The affected foot wound secretion culture was pan-resistant Pseudomonas aeruginosa. According to the wound healing time, they were divided into wound healing group (26 cases, healing time ≤3 months) and wound un-healing group (23 cases, healing time >3 months). The general information, clinical indicators and treatment between two groups were compared, and the factors related to healing was analyzed by multi-factor unconditioned Logistic regression analysis. Results Compared with those in wound un-healing group, the blood flow volume of dorsal artery of affected foot and negative pressure attraction rate in wound healing group were higher: (43.59±2.71) ml/min vs. (23.14±5.39) ml/min, 76.9% (20/26) vs 47.8%(11/23), and the urinary micro-albumin was lower: (67.01±3.32) mg/L vs. (234.03±6.71) mg/L. There were significant differences (P<0.05 or <0.01). Multi-factor unconditioned Logistic regression analysis showed that the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa were the blood flow volume of dorsal artery of affected foot (regression coefficient was -5.551, P=0.001), urinary micro-albumin (regression coefficient was 0.127, P=0.007) and negative pressure attraction (regression coefficient was -2.244, P=0.042). Conclusion The blood flow volume of dorsal artery of affected foot, urinary micro-albumin, negative pressure attraction are the factors related to healing of severe diabetic foot gangrene infected with pan-resistant Pseudomonas aeruginosa. Key words: Diabetic foot; Pseudomonas aeruginosa; Wound healing; Influencing factor