[A comparative study of vancomycin loaded bone cement in the treatment of Wagner Ⅱ-Ⅳ diabetic foot]
He Lyu1, Hai-Bing Zhu1, Yi-Ping Ma1
1Paediatrics of Foot and Ankle, Zhoushan Hospital of Traditional Chinese Medicine, Zhoushan 316000, Zhejiang, China.
Objective:
To investigate the clinical effect of vancomycin bone cement in the treatment of diabetic foot ulcer (DFU) ruptured Wagner gradeⅡ-Ⅳ.
Methods:
From March 2019 to April 2021, 32 patients with Wagner gradeⅡ-Ⅳ diabetic foot were divided into vacuum sealing drainage (VSD) group and bone cement group according to different treatment methods. There were 16 cases in VSD group, 8 males and 8 females;the age ranged from 66 to 81 (70.50±7.20) years, and the course of disease ranged from 8 to 40 (27.56±8.55) months;Wagner gradeⅡin 2 cases, grade Ⅲin 7 cases and grade Ⅳin 7 cases;debridement and VSD were used. There were 16 cases in the bone cement group, 9 males and 7 females;the age ranged from 63 to 79 (69.56±7.29) years, and the course of disease ranged from 11 to 39(22.75±11.43) months;Wagner gradeⅡ in 2 cases, grade Ⅲin 5 cases and grade Ⅳ in 9 cases;vancomycin loaded bone cement was used for treatment. The types of bacteria, negative time of bacterial culture, skin healing time, hospital stay, operation times and complications were observed and compared between two groups.
Results:
All patients were followed up for 3 to 6 (4.00±1.07) months. The bacterial negative time, skin healing time and hospital stay in bone cement group were significantly lower than those in VSD group (P<0.05). The median number of operations in both groups was 2, and there was no significant difference (P>0.05). According to the analysis of pathogens in two groups, there were 13 cases of G+ patients, 14 cases of G- patients and 5 cases of mixed bacteria. The number of G+, G- and mixed bacteria in bone cement group was 6, 7 and 3 cases respectively, and the number of G+, G- and mixed bacteria in VSD group was 7, 7 and 2 cases respectively. The wounds of 32 patientsin two groups healed completely without complications.
Conclusion:
Vancomycin loaded bone cement is effective in the treatment of Wagner grade Ⅱ-Ⅳ diabetic foot ulceration wounds. It can reduce the length of hospital stay, shorten the healing time of skin and kill pathogens as soon as possible. It is one of the effective methods to treat Wagner gradeⅡ-Ⅳdiabetic foot ulceration.
