Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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The Application of Vacuum-Assisted Closures According to the Texas Staging System in the Treatment of Infective Diabetic Foot Ulcers

감염성 당뇨 족부 궤양 치료에서 Texas 기준 체계에 따른 음압치료 적용

  • Lim, Seong-An (Department of Orthopedic Surgery, Kwangju Christian Hospital) ;
  • Choi, Yong-Soo (Department of Orthopedic Surgery, Kwangju Christian Hospital) ;
  • Jang, Young-Jae (Department of Orthopedic Surgery, Kwangju Christian Hospital) ;
  • Baek, Sung-Nyun (Department of Orthopedic Surgery, Kwangju Christian Hospital) ;
  • Bae, An-Na (Department of Orthopedic Surgery, Kwangju Christian Hospital)
  • Received : 2021.07.12
  • Accepted : 2022.02.08
  • Published : 2022.06.15
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Abstract

Purpose: A group of patients who were hospitalized for diabetic foot ulcers was classified according to the University of Texas Staging System for Diabetic Foot Ulcers, and we attempted to evaluate whether this staging system could be a criterion for treatment success using vacuum-assisted closure (VAC) technique. Materials and Methods: A total of 32 patients were diagnosed with diabetic foot ulcers according to the University of Texas Staging System for Diabetic Foot Ulcers. Of these, 24 patients who were evaluated as stage B according to the staging system were classified as Group 1, and 8 patients in stage D were classified as Group 2. After applying VAC, the treatment success rate was compared by evaluating the size and severity of ulcers between the two groups. Results: The grade of granulation after VAC was on average 3.75±0.53 in Group 1 and 2.25±0.71 in Group 2. There was better granulation after VAC application in Group 1 (p<0.01). The success rate of the treatment was 22 cases (91.67%) in Group 1 and one case (12.5%) in Group 2. Thus there were statistically significant differences in the success rate of treatment between groups 1 and 2 (Pearson's chisquare test, p=0.01; odd ratio 77.00, 95% confidence interval [CI] 1.26~14.66; relative risk 4.30, 95% CI 1.26~14.66). Conclusion: These results suggest that there was a higher success rate of treatment with VAC in stage B patients. The University of Texas Staging System for Diabetic Foot Ulcers can thus be an index for applying VAC to patients with infective diabetic foot ulcers.

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References

  1. Younis BB, Shahid A, Arshad R, Khurshid S, Ahmad M, Yousaf H. Frequency of foot ulcers in people with type 2 diabetes, presenting to specialist diabetes clinic at a Tertiary Care Hospital, Lahore, Pakistan. BMC Endocr Disord. 2018;18:53. doi: 10.1186/s12902-018-0282-y.
  2. Sabir M, Kanwal R, Shahzad MN, Khan MMUR. Wagner versus the university of Texas classification of diabetic foot ulcers: a descriptive study In Nishter hospital Multan. Ann Pak Inst Med Sci. 2018;14:19-24.
  3. Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Harkless LB, Boulton AJ. A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems. Diabetes Care. 2001;24:84-8. doi: 10.2337/diacare.24.1.84.
  4. Jain AKC. A new classification of diabetic foot complications: a simple and effective teaching tool. J Diabet Foot Complicat. 2012;4:1-5.
  5. Kota SK, Kota SK, Meher LK, Sahoo S, Mohapatra S, Modi KD. Surgical revascularization techniques for diabetic foot. J Cardiovasc Dis Res. 2013;4:79-83. doi: 10.1016/j.jcdr.2012.10.002.
  6. Tresierra-Ayala MA, Rojas AG. Association between peripheral arterial disease and diabetic foot ulcers in patients with diabetes mellitus type 2. Med Univ. 2017;19:123-6. doi: 10.1016/j.rmu.2017.07.002.
  7. Ingber DE, Folkman J. Mechanochemical switching between growth and differentiation during fibroblast growth factor-stimulated angiogenesis in vitro: role of extracellular matrix. J Cell Biol. 1989;109:317-30. doi: 10.1083/jcb.109.1.317.
  8. Pietramaggiori G, Liu P, Scherer SS, Kaipainen A, Prsa MJ, Mayer H, et al. Tensile forces stimulate vascular remodeling and epidermal cell proliferation in living skin. Ann Surg. 2007;246:896-902. doi: 10.1097/SLA.0b013e3180caa47f.
  9. Jung HG, Ki S, Kim B, Kim K, Kim Y, Cho Y, et al. Application of vacuum-assisted closure in difficult wounds. J Korean Orthop Assoc. 2012;47:41-7. doi: 10.4055/jkoa.2012.47.1.41.
  10. Karatepe O, Eken I, Acet E, Unal O, Mert M, Koc B, et al. Vacuum assisted closure improves the quality of life in patients with diabetic foot. Acta Chir Belg. 2011;111:298-302. doi: 10.1080/00015458.2011.11680757.
  11. Prince HP, Sreejayan MP. Outcome of diabetic foot ulcer management with vacuum assisted closure. J Med Sci Clin Res 2017;5:19314-8. doi: 10.18535/jmscr/v5i3.157.
  12. Nather A, Chionh SB, Han AY, Chan PP, Nambiar A. Effectiveness of vacuum-assisted closure (VAC) therapy in the healing of chronic diabetic foot ulcers. Ann Acad Med Singap. 2010;39:353-8. doi: 10.47102/annals-acadmedsg.V39N5p353.
  13. Paola LD, Carone A, Ricci S, Russo A, Ceccacci T, Ninkovic S. Use of vacuum assisted closure therapy in the treatment of diabetic foot wounds. J Diabet Foot Complicat. 2010;2:33-44.
  14. Lambert KV, Hayes P, McCarthy M. Vacuum assisted closure: a review of development and current applications. Eur J Vasc Endovasc Surg. 2005;29:219-26. doi: 10.1016/j.ejvs.2004.12.017.