Observation And Analysis Of VSD Combined With Peracetic Acid Solution Washing Therapy For Diabetic Foot

Objective: To assess the therapeutic effect treating diabetic foot ulcers(DFUs)by using VSD alone and VSD+Peracetic Acid Solution and VSD+normal saline solution with the comparison of the diabetic foot wounds and related indicators.Methods: 48 Patients diagnosed as diabetic foot(grade ? or ?)were brought into the study,among them16 were given VSD therapy,16 were given VSD+NS,and 16 were given VSD+PAA.After admitted to hospital,local conditions of wounds were observed,and on the second day the body-related indicators were detected.Patients receive curation of nutritional support and microcirculation improve,and they have to control their blood sugar at a proper level.Wounds reveived surgical debridment,removing the necrotic tissue and foreign bodies as far as possible,and then stanch bleeding.After that,the central wound granulation tissue was taken,washed with PBS and stored in liquid nitrogen,for subsequent detection.Then wounds were covered with VSD,the negative pressure should be controlled at 180 mmHg.Patients were distributed to three group randomly,and receive VSD,VSD+NS or VSD+PAA therapy respectively.During the washing treatment,if the tube was blocked,we should change a new tube or a new VSD according the condition.At the 7th day,take off the VSD,note down the data about the wound and other related indicators.Then take central wound granulation tissue once again,for the subsequent related test.Results: 1.No significant difference was found in the three groups on ages,area of the wound,WBC,CRP,ESR,IL-6,TNF-?,EGF and FGF.This result demonstrated that the interference of non-treatment factors was excluded and there is a good comparability among the three groups.2.After the treatment VSD,VSD+NS or VSD+PAA therapy,serum WBC,ESR,CRP,IL-6,TNF-?,EGF and FGF levels of patients in VSDA and VSDN group were significantly improved(P<0.05),and serum WBC,EGF level in VSD group declined obviously(p<0.05),while the other body and local indicators did not improve obviously(P>0.05).3.The comparation of VSDA and VSDN group showed that serum WBC,ESR,CRP,IL-6,TNF-?,EGF and FGF levels improved significantly.(p<0.05).Conclusion:VSD+PAA treatment have a more positive influence on the content of EGF and FGF on the wound than VSD and VSD+NS treatment,and can decrease the extent of infection and inflammation factor more obviously than the other two treatment.