Clinical cpmparision of different treatment methods for wounds of acute infectious diabetic foot moist gangrene

Objective To explore clinical effects about surgical operation treatment and non-surgical operation treatment methods for acute infectious diabetic foot moist gangrene wounds, and to provide guidance for treatment of acute infectious diabetic foot moist gangrene wounds. Methods To retrospectively analyze 63 cases of acute infectious diabetic foot moist gangrene patients treated by the Department of Burns, Guangzhou First People′s Hospital from January 2014 to March 2017. According to the clinical situation of acute infectious diabetic foot moist gangrene wounds, the surgical treatment[including debridement surgery and debridement surgery plus negative pressure wound therapy (NPWT)] and non-surgical treatment (including ultrasonic debridement and routine dressing) was performed respectively. The 63 cases were divided into surgical treatment group(44 cases) and non-surgical treatment group(19 cases) on the basis of the differences of treatments. By analyzing the changes of blood glucose before and after wound treatment, the inflammation around the wound, the growth of granulation tissue and the total amputation rate, the clinical effect of different clinical treatment on diabetic foot moist gangrene wound was evaluated. The data were compared by t test, Radit analytical method and chi-square test. Results Both the surgical treatment group and the non-surgical treatment group had obvious blood glucose reduction before and after operation, the difference were statistically significant (with P values below 0.05). In the field of inflammatory reaction and granulation tissue formation, the surgical treatment group had 95%CI in the control of inflammatory reaction (0.808-1.149), and in granulation generation, the following 95%CI was 0.792-1.133, obviously better than non-surgical treatment group, the difference was statistically significant. At the same time, Radit analysis was performed on the debridement surgery and debridement plus NPWT in the surgical treatment group. The results suggested that there was no significant difference in granulation between the two treatment methods. The 95%CI was 0.2466-0.6466. The amputation rate was 9% in the surgical treatment group, and 37% in the non-surgical treatment group, it was suggesting that surgical treatment can significantly reduce the amputation rate, the difference was statistically significant (χ2=5.30, P<0.05). Conclusions For acute infectious diabetic foot moist gangrene wounds, debridement surgery or plus NPWT should be actively performed to remove necrotic tissue as much as possible, actively control infection, and promote granulation growth. That is of great significance for limb salvage treatment of diabetic foot moist gangrene. Key words: Diabetic foot; Gangrene; Negative-pressure wound therapy; Wound treatment; Acute infectivity