Value of negative pressure wound therapy for lower limb salvage of patients with severely infected diabetic foot

Abstract

Objective To evaluate negative pressure wound therapy (NPWT) for limb salvage of diabetic foot with severe infection.Methods This study includes the severely infected diabetic foot patients that is classified as Vagner grade Ⅲ and higher.Among the 183 patients,162 received debridement plus NPWT on the base of one-stop surgical treatment,including blood glucose control,anti-infectious therapy,symptomatic treatment,revascularization of the occluded lower limb arteries.The debridement and NPWT was repeatedly done every 3 to 7 days,till the wound became clean and was covered by granulation tissue,and cured by scar healing or dermoplasty.The 21 cases without NPWT served as control group.Results In the study group,there were 2 above-knee amputations,8 below-knee amputations,20 half-foot amputations,and 132 toe amputations.The above-and below-knee amputation ratio was 1.2％ and 4.9％,the limb salvage ratio was 93.9％.In the control group,the ratio was 14.4％,23.8％,and 42.8％ respectively.The average grade in the NPWT group was higher than the comparison group by 1.598,with an absolute value of the t-test equal to 4.96,P ＜ 0.000 1.Conclusions NPWT is an important and effective measure in the procedure of surgical treatment for severely infected wound of diabetic foot,increasing limb rescue rate of diabetic foot of Wagner grade Ⅲ and higher,and improving the quality of life. Key words: Diabetic foot; Negative-pressure wound therapy; Limb salvage; Amputation