Effect of abductor halluces muscle flap combined with negative pressure wound therapy in the treatment of sinus tract in diabetic foot

Abstract

Objective To explore the therapeutic effect of abductor halluces muscle flap combined with negative pressure wound therapy in the treatment of sinus tract in diabetic foot. Methods From January 2013 to December 2015, 41 patients suffering diabetic foot with sinus tract were included in the department of burns, Fourth Clinical Hospital of Peking University. They were divided into experimental group (n=20) and control group(n=21) by simple-randomization. All patients were under the effective treatments of anti-infection, anti-coagulation and control of blood sugar, blood pressure as well as blood lipid level. The patients in the experimental group were adopted two subsequent operations. In the first operation, they received rational debridement and negative pressure wound therapy. The sinus tract was filled by abductor halluces muscle flap in the second operation .The patients in the control group received rational debridement and negative pressure wound therapy throughout. The wound healing time, average hospital stays, average medical cost and operation times were compared between the two groups by using independent-samples t test. Results The average healing time of wound in experimental group (20.8±1.8) d was obviously shorter than the control group (34.2±3.3) d, there was significant difference between the two groups (t=-16.40, P<0.05). The average hospitalization time (23.4±2.3) d in experimental group was obviously less than the control group (36.7± 3.7) d, there was significant difference between the two groups (t=-13.87, P<0.05). The average medical cost in the experimental group (31710.45±1092.70) yuan was obviously less than the control group (42528.57±1071.05) yuan, there was significant difference between the two groups (t=-32.01, P<0.05). The number of operation in the experimental group (2.0±0.0) times was less than the control group (4.7±0.7) times, there was significant difference between the two groups (t=-13.87, P<0.05). Conclusion The treatment of abductor halluces muscle flap combined with negative pressure wound therapy can provide satisfactory healing for sinus tract in diabetic foot. Rational debridement is the key prerequisite for healing of sinus tract in diabetic foot. Key words: Surgical flaps; Muscles; Negative-pressure wound therapy; Diabetic foot; Debridement; Sinus tract