Vacuum sealing drainage combined with skin grafting in the treatment of 30 cases of diabetic foot

Objective To summarize the experience of vacuum sealing drainage (VSD) combined with skin grafting in the treatment of diabetic foot. Methods The clinical data of 30 patients with diabetic foot admitted from August 2016 to August 2017 in the Department of Vascular Ulcer Surgery, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were retrospectively analyzed. All patients were of Wagner grade 4 to 5. The treatment methods included debridement, VSD and skin grafting. The length of hospital stay, limb function and appearance, and scar contracture in the skin graft area were observed. After discharge, 30 patients were followed up by telephone and outpatient clinic for 3 to 12 months, with an average of 5 months. Limb appearance, function and ulcer recurrenceobservation were observed. Results Three patients had ischemia of the foot, CT angiography (CTA) showed occlusion of the lower extremity arteries. Superficial femoral artery was opened, balloon dilatation and stenting were performed. After debridement, skin grafting was performed after VSD, and the wound healed completely. After debridement and VSD treatment of 23 patients, fresh granulation tissue grew and the wound healed completely after skin grafting. In the other 4 cases, due to serious wound infection, there were more tissue defects after debridement. After intermittent debridement and VSD treatment, the granulation tissue grew well and most of the grafts survived after skin grafting. All diabetic foot wounds were cured with an average hospitalization time of 35 days (27 to 50 days); 27 cases had good skin color, good elasticity and good recovery of foot movement function; 3 case had small ulcers due to friction at the plantar or foot front, which were changed dressing for about a week after outpatient treatment. All patients healed without recurrenc during follow-up period. Conclusion On the basis of debridement, VSD combined with skin grafting can shorten the course of disease and improve the limb salvage rate. Key words: Diabetic foot; Negative-pressure wound therapy; Skin transplantation