Therapeutic Effection Of Different Concentrations Of Peracetic Acid On Diabetic Foot Wounds

Objective: By comparing the shrinkage rate of diabetic foot wounds and relevant indexes changes among experimental groups(Group A,B,C and D)and control group(Group E),to discuss that if the therapeutic effect of peracetic acid used in the wounddressing therapy is superior to the 0.5% iodophor disinfectant utilized in the conventional wound-dressing therapy;and screen out the optimal concentration of peracetic acid for the wound-dressing via between-group comparisons.Methods: According to the principle of random allocation,the patients that up to the standard were randomly divided into each group;and anti-infection treatment and nutrition support treatment were given after the grouping,and the blood glucose was controlled to an appropriate level.The patients' venous blood collected surrounding to the wound were sent to the laboratory department for undergoing quantitative determination on relevant indexes prior to the first and fourth wound-dressing.The wound-dressing therapy was done every other day in each group,and four rounds of wound-dressing therapy were conducted on the 1st,3rd,5th and 7th day.In the process of wound-dressing therapy,firstly the wound was rinsed and tried to clear away the necrotic issues and foreign matters on the wound;and then the gauze sufficiently soaked with peracetic acid with responding concentration in different groups or 0.5% iodophor disinfectant was spread on the wound surface for wet compression and binding up.The wound area was measured and the wound shrinkage rate was calculated at the 1st and 4th wound-dressing therapy,and relevant data was recorded.Small amount of tissue was collected and the supernate after centrifugal treatment was saved in-80? temperature.And then the EFG(Epidermal Growth Factor)and b FGF(Basic Fibroblast Growth Factor)content measurement was conducted in the later period of the test.And finally all the data were gathered,the therapeutic effect of each group was evaluated by the statistical analysis.Results: No severe complications occurred among the 40 patients during the therapeutic period,and the wound had varying degree of healing.The statistical analysises for relevant indexes were as follows: a.The general conditions of the patients: the patient cases,gender,age,diabetic courses,serum total protein,wound formation time,glycosylated hemoglobin and the size of wound in each group after admitting were statistically analyzed,the differences had no statistical significance(with all P> 0.05),and it was considered that there were no apparent differences among groups.B.The rate of wound shrinkage and relevant indexes: one-way analysis of variance was conducted on EGF,b FGF,IL-6,TNF-?,WBC and CRP among groups prior to the therapy,with all P>0.05.And the one-way analysis of variance was once again conducted on the same items among groups,with all P<0.05,the differences were statistically significant.The contrast prior to and post the therapy: The content changes of EGF,b FGF,IL-6,TNF-?,WBC and CRP and the changes of wound shrinkage prior to and post the therapy was calculated,the between-group comparison was conducted on each index,the control group(E group)was compared with the experiment groups(Group A,B,C and D),with all P<0.05,the differences were statistically significant.And then between-group comparison was conducted among each experiment group,among the EGF,b FGF,IL-6,TNF-?,WBC and wound shrinkage rate,Group A was compared with Group D,with all P>0.05.Group B was compared with Group C,with all P >0.05.Group A was compared with Group B and Group C,with all P<0.05;the differences were statistically significant.Group D was compared with Group B and Group C,respectively,with all P<0.05,the differences were statistically significant.In the CRP,mutual comparison was conducted among Group A,Group B and Group D,with all P>0.05.Group C was compared with Group A,B and D,with all P<0.05;the differences were statistically significant.Conclusion:The extent of improvement of peracetic acid wound-dressing therapy is superior to the iodophor wound-dressing therapy on the EGF,b FGF,IL-6,TNF-?,WBC,CRP and wound shrinkage among patients with diabetic foot.Moreover,the wet compression therapy utilizing peracetic acid with 0.167%-0.3% concentration had the optimal extent of improvement.