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Promotion of diabetic deer healing by vacuum-assisted closure therapy

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
Issue:
5
DOI:
10.3760/cma.j.issn.1674-1927.2008.05.003
Key Word:
糖尿病;糖尿病足;皮肤溃疡;创面床准备;清创;负压封闭吸引;创面愈合;胶原;Diabetes meilitus;Diabetic foot;Skin ulcer;Wound bed preparation;Debridement;Vacuum-assisted closure;Wound healing;Collagen

Abstract: Objective To observe the efficacy of local treatment on diabetic ulcer by using vacuum-assisted closure (VAC) way based on " wound bed preparation (WBP)" theory. Methods Twenty-seven patients admitted to our hospital from Jan 2000 to Jan 2005, 8 patients from Jan 2005 to June 2007, were respectively divided into control group and trial group. All the 35 patients were suffered from diabetic skin ulcer. Conventional and systematic therapy was adopted for beth two groups. And vacuum-assisted closure was applied in trial group when debridement was practiced in black or/and yellow stage. The time consuming of wounds evolving from inferior stage to superior one, one-step operation healing rate, wounds bacterial detection at admission and 1,2, 3 weeks post vacuum-assisted closure treatment were observed. Biopsies of different stages were harvested to make histology observations by HE stain and Ⅰ and Ⅲ type collagen analysis at yellow and red stage by picrosirius-polarization technique and image analysis. Results Speed of wounds evolving to other stages and one-step operation healing rate were superior in trial group than those in control group (100% vs 46%, P <0.05). No bacteria was detected in trial group but the rate still persisted at 66.7% in control group at the time of 2 weeks post-treatment(P < 0. 05). HE stain showed that healing process at each stage in trial group was like an acute wound process. Total Ⅰ and Ⅲ type collagen in trial group was 12.28% and 24. 77 % in control group (P < 0.01). Conclusions Vacuum-assisted closure based on WBP theory is a good treatment to promote diabetic ulcer healing.

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