Analysis of the Effect of Antibiotic Bone Cement in the Treatment of Diabetic Foot Ulcer through Tibia Transverse Transport. Issue 9 (5th August 2022)

• Record Type: Journal Article
• Authors: Ding, Xiaofang; Yuan, Yusong; Lu, Hao; Wang, Yuanli; Ji, Kunyu; Lv, Haorun; Xu, Hailin; Zhou, Junlin
• Is Part Of: Orthopaedic surgery. Volume 14:Issue 9(2022)
• Page Start: 2141
• Page End: 2149
• Publication Date: 2022-08-05
• Subjects: Antibiotic bone cement -- Diabetic foot ulcer -- Infection -- Tibial transverse translation; Orthopedic surgery -- Periodicals; Orthopedics -- Periodicals; Musculoskeletal system -- Wounds and injuries -- Periodicals; 617.47005
• DOI: 10.1111/os.13412
• Languages: English
• ISSNs: 1757-7853

Abstract

Abstract : Objective: To explore the efficacy of antibiotic bone cement (ABC) combined with the modified tibial transverse transport (mTTT) on the treatment of severe diabetic foot with infection. Methods: A retrospective cohort study was conducted of 243 patients with TEXAS grade 3/4 stage D diabetic foot ulcers from December 2016 to December 2019. A total of 115 patients treated with mTTT were classified as the mTTT group (78 male and 37 female, mean age: 70.4 ± 6 years) and 128 patients who were treated with ABC combined with mTTT were in the ABC + mTTT group (89 male and 39 female, mean age: 68.9 ± 8 years). Follow‐up records during treatment and 6 months after surgery were collected, including the time required for white blood cells (WBC) and C‐reactive protein (CRP) to return to normal range, wound healing time, pain visual analog scale (VAS), ankle‐brachial index (ABI), foot skin temperature, transcutaneous oxygen pressure measurement (TcPO2 ), complications, and other indicators. Normally distributed data were compared using the independent sample t‐test, non‐normally distributed data were analyzed by one‐way ANOVA analysis of variance. Results: There were 128 cases in the ABC + mTTT group (89 male and 39 female, mean age: 68.9 ± 8 years) treated with ABC and mTTT, and 115 cases in the TTT group (78 male and 37 female, mean age: 70.4 ± 6 years) treated with mTTT alone. The time required for WBC and CRP to return to the normal range and wound healing time in the ABC + mTTT group were significantly shorter than those in the mTTT group (12.9 ± 4.6 vs. 22.6 ± 1.6 days, t = 3.979, p < 0.001; 25.3 ± 1.3 vs. 31.3 ± 2.3 days, t = 4.261, p = 0.001; 11.9 ± 3.8 vs. 15.9 ± 3.9 days, t = 4.539, p < 0.001). There were no significant intergroup differences in the foot skin temperature, VAS score, ABI, and TcPO2 ( t = 0.349, 0.542, 0.765, 0.693 while all p > 0.05). Conclusion: Although the application of ABC with mTTT for treatment of diabetic foot ulcers did not affect the wound healing time and ankle blood supply in the mid‐term, it could control ulcer infection faster and accelerate wound healing. Abstract : The antibiotic bone cement (ABC) was shaped and perforated according to the shape and size of the wound. The cooled ABC was filled in the infection and tissue defects, covering the wound surface, and fixing it on the wound surface with sutures. The auxiliary materials were replaced every day or every other day according to the exudation of the wound. The ABC was retained for 4–8 weeks, and the decision to continue covering with the ABC depended on the culture results of the wound secretion. It was certified that this technique could control ulcer infection faster than traditional methods and accelerate ulcer wound healing.