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手术治疗糖尿病幻觉感染的早期结果和并发症

Kaissar Yammine¹, Mohammad Omar Honeine², Joseph Mouawad²

¹Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, School of Medicine, Beirut, Lebanon; Diabetic Foot Clinic, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon; Center for Evidence-Based Anatomy, Sport & Orthopedics Research, Beirut, Lebanon.

Annals of vascular surgery

|April 3, 2024

概括

对于严重的糖尿病足部感染而言,保守性手术可能会比截肢更少的早期并发症,尽管需要更多的研究. 这项研究比较了幻觉糖尿病足部感染 (DFI) 治疗的结果.

科学领域:

足部外科手术足部外科手术
糖尿病脚并发症糖尿病脚并发症
传染病管理传染病管理

背景情况:

严重感染的大脚的糖尿病通常需要手术干预.
治疗方案包括保守的手术和截肢,这取决于伤口的严重程度和骨髓炎.
关于这些手术对幻觉糖尿病足部感染 (DFI) 的结果和并发症的比较数据有限.

研究的目的:

为了比较保守手术的早期结果和并发症与截肢治疗幻觉糖尿病足部感染 (DFI).
为了评估后续手术的频率,由于初始治疗后的深度感染复发.

主要方法:

对37名患有晚期糖尿病足 (DFU) 的患者进行了回顾性比较研究 (瓦格纳等级2-4).
最初的治疗包括24种保守的手术和13种截肢.
主要结局是对深层感染复发后续手术的比率;进行了统计分析.

主要成果:

10名患者 (27%) 需要进一步的手术,因为深层感染复发.
保守性手术的复发率为16.7%,截肢的复发率为46% (P=0.054).
随后的截肢率为保守组的8.3%,截肢组的23.1% (P=0.2).

结论:

较高的初始幻觉感染严重程度 (瓦格纳等级) 与早期手术并发症的增加相关,特别是在截肢后.
目前对感染程度的评估工具可能不足.
考虑基于成像的更近距离的外科边缘可以减少重新手术的需要.

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