Application of noninvasive skin-stretching device in wound healing of diabetic foot

Abstract

Objective To evaluate the clinical value of noninvasive skin-stretching device in the healing of diabetic foot after toe amputation or debridement. Methods A total of 51 diabetic patients with diabetic foot gangrene at Wagner stage 4 after toe amputation or debridement were recruited in the study from May 2017 to March 2018 by using a prospective cohort design. The patients were assigned into trial group (n=17) and control group (n=34) and matched by 1∶2 ratio [age:(54.9±10.8) yrs vs (59.2±11.3) yrs, duration of diabetic foot: 1.0(1.0, 4.1) months vs 1.5(1.0, 2.0) months]. All patients underwent basic treatment and vacuum sealing drainage therapy until exposing bones were covered by fresh granulation tissues and wound inflammation disappeared. The wounds of control group were received regular dressing change, and adhesive noninvasive skin-stretching devices were applied to the wounds of trial group. The wounds were observed from the 1st day to the day of wound healing or 3 months after surgery. Healing rates were compared, and Kaplan-Meier survival analysis was used for comparing cumulative wound healing rate over time between two groups. Results The healing rate of trial group was significantly higher than that of control group (94.1% vs 58.8%, χ2=5.206, P<0.05). The differences of Kaplan-Meier healing time curve between two groups were statistically significant (P<0.01). Median of healing time in trial group was significantly shorter than that in control group [42 (41, 59) d vs 78 (50, 90) d, Z=3.30, P<0.01]. Taking the end of the last vacuum sealing drainage therapy as the starting point of time, the differences of Kaplan-Meier healing time curve between two groups were statistically significant (P<0.01), and the median of healing time in trial group was significantly shorter than that in control group [13 (8, 14) d vs 42 (26, 42) d, Z=4.845, P<0.01]. Conclusion The application of noninvasive skin-stretching device in diabetic foot gangrene in the repairation stage after surgery can reduce wound healing time and increase wound healing rate. Key words: Diabetic foot; Negative-pressure wound therapy; Wound healing; Skin-stretching device