Effect of small incision counterpart drainage and dressing change technique on rehabilitation of foot function in patients with diabetic foot fascial space infection

Objective To investigate the effect of small incision counterpart drainage and dressing change technique on foot function in patients with diabetic foot muscle fascial space infection. Methods From January 2018 to July 2018, 60 patients with diabetic foot fascial space infectioniabetic foot were treated in the Wound Care Center of Xuanwu Hospital Capital Medical University.The patients were randomly divided into two groups according to the random number table method, observation group and control group, 30 cases in each group. The observation group underwent counterpart drainage and dressing with small incision to normal tissues. Necrotic tissue was gradually cleared away and the lipid hydrocolloid dressing was used for drainage after debridement. If inflammation spread, debridement continued. When the redness and swelling of the affected foot began to recede, the removal of the drainage strip was taken into consideration. Finally, the incision between sole and back of the foot was closed and covered with wet and closed dressing. The control group underwent thorough debridement through a large incision. In the later stage, sterile scissors or surgical blades were repeatedly used to debridement the necrotic tissue to control the infection. The affected foot was rinsed with 0.9% sodium chloride solution and dried with sterile gauze. Functional dressings such as silver ion dressings were used to cover it. The pain score, incision healing time, patient satisfaction, and the health status of the patients in the two groups, including the physiological field (physical functions, physiological functions, physical pain and general health) and the psychological field (energy, social function, emotion functional and mental health) were calculated and surveyed. Data were compared by t test. Results The observation group′s pain score, incision healing time, and patient satisfaction were (3.76±1.94) points, (39.09±10.55) d and (94.21±6.77) points, and the control group were [(5.31 ± 2.48) points, (47.11 ± 7.13) d and (82.09 ± 7.26) points], the differences were statistically significant (t=2.70, 3.45, 6.69; with P values below 0.05). In addition, the scores of the physiological field (physical functions, physiological functions, physical pain and general health) scores of the observation group were (79.99±14.12), (71.33±10.21), (77.47±12.78) and (81.15±12.77) points, respectively and those in the control group were [(72.54±12.01), (63.03±11.67), (67.19±11.12), (73.08±10.54) points], the differences were statistically significant (t=2.20, 2.93, 3.32, 2.67; with P values below 0.05); the scores of various indicators in the psychological field (energy, social function, emotion functional and mental health) of the observation group were (83.64±10.88), (92.55±11.32), (92.67±25.55) and (86.34±9.77) points, and those in the control group were [(76.11±15.02), (70.31±16.23), (73.34±21.21) and (78.98±11.01) points], the differences were statistically significant (t=2.22, 6.16, 3.19, 2.74; with P values below 0.05). Conclusions Counterpart drainage and dressing change with small incision is of less damage and bleeding, safer, more reliable, and much better than conventional dressing change. Moreover, the appearance and function of the diabetic foot can be preserved, and the quality of life and health of the patients can be significantly improved. Key words: Diabetic foot; Infection; Drainage; Quality of life