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Ji S, Liu X, Huang J, Bao J, Chen Z, Han C, Hao D, Hong J, Hu D, Jiang Y, Ju S, Li H, Li Z, Liang G, Liu Y, Luo G, Lv G, Ran X, Shi Z, Tang J, Wang A, Wang G, Wang J, Wang X, Wen B, Wu J, Xu H, Xu M, Ye X, Yuan L, Zhang Y, Xiao S, Xia Z. Consensus on the application of negative pressure wound therapy of diabetic foot wounds. BURNS & TRAUMA 2021; 9:tkab018. [PMID: 34212064 PMCID: PMC8240517 DOI: 10.1093/burnst/tkab018] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/17/2021] [Indexed: 02/06/2023]
Abstract
Because China is becoming an aging society, the incidence of diabetes and diabetic foot have been increasing. Diabetic foot has become one of the main health-related killers due to its high disability and mortality rates. Negative pressure wound therapy (NPWT) is one of the most effective techniques for the treatment of diabetic foot wounds and great progress, both in terms of research and its clinical application, has been made in the last 20 years of its development. However, due to the complex pathogenesis and management of diabetic foot, irregular application of NPWT often leads to complications, such as infection, bleeding and necrosis, that seriously affect its treatment outcomes. In 2020, under the leadership of Burns, Trauma and Tissue Repair Committee of the Cross-Straits Medicine Exchange Association, the writing group for ‘Consensus on the application of negative pressure wound therapy of diabetic foot wounds’ was established with the participation of scholars from the specialized areas of burns, endocrinology, vascular surgery, orthopedics and wound repair. Drawing on evidence-based practice suggested by the latest clinical research, this consensus proposes the best clinical practice guidelines for the application and prognostic evaluation of NPWT for diabetic foot. The consensus aims to support the formation of standardized treatment schemes that clinicians can refer to when treating cases of diabetic foot.
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Affiliation(s)
- Shizhao Ji
- Burn Institute of PLA, Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China
| | - Xiaobin Liu
- Burn Institute of PLA, Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China
| | - Jie Huang
- Burn Institute of PLA, Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China
| | - Junmin Bao
- Burn Institute of PLA, Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China
| | - Zhaohong Chen
- Fujian Burn Institute, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Gulou District, Fuzhou, 350001, China
| | - Chunmao Han
- Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, College of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou, 310009, China
| | - Daifeng Hao
- No. 3 Department of Burns and Plastic Surgery and Wound Healing Center, The Fourth Medical Center of Chinese PLA General Hospital, No 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Jingsong Hong
- Foot and Ankle Surgery Department, Guangzhou Zhenggu Orthopedic Hospital, No. 449 Dongfeng Middle Road, Yuexiu District, Guangzhou, 510031, China
| | - Dahai Hu
- Department of Burns and Cutaneous Surgery, The First Affiliated Hospital of Air Force Medical University, No. 127 West Changle Road, Xincheng District, Xi'an, 710032, China
| | - Yufeng Jiang
- Wound Healing Department, PLA Strategic Support Force Characteristic Medical Center, No. 9 Anxiang North Lane, Chaoyang District, Beijing, 100101, China
| | - Shang Ju
- Department of Peripheral Vascular, Beijing University of Chinese Medicine, Dongzhimen Hospital, Hai Yun Cang on the 5th, Dongcheng District, Beijing, 100700, China
| | - Hongye Li
- Department of Orthopedics, Zhejiang University School of Medicine, Sir Run Run Shaw Hospital, No. 3 East Qinchun Road, Shangcheng District, Hangzhou, 310016, China
| | - Zongyu Li
- Department of Burns, The Fifth Hospital of Harbin, No. 27 Jiankang Road, Xiangfang District, 150030, Harbin, China
| | - Guangping Liang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no. 29, Shapingba District, Chongqing, 400038, China
| | - Yan Liu
- Department of Burn, Shanghai Jiaotong University, School of Medicine Affiliated Ruijin Hospital, No. 197 Ruijin Road (No.2), Huangpu District, Shanghai, 200025, China
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no. 29, Shapingba District, Chongqing, 400038, China
| | - Guozhong Lv
- Department of Burn Surgery, the Third People's Hospital of Wuxi, No. 585 North Xingyuan Road, Wuxi, 214043, China
| | - Xingwu Ran
- Innovation Center for Wound Rpair, Diabetic Foot Care Center, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, China
| | - Zhongmin Shi
- Department of Orthopedics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, No. 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Juyu Tang
- Department of Hand and Microsurgery, Xiangya Hospital of Central South University, No. 87 Xiangya Road, Kaifu District, Changsha, 410008, China
| | - Aiping Wang
- Diabetic Foot Centre, The Air Force Hospital From Eastern Theater of PLA, Nanjing, No.1 Malu Road, Qinhuai District, 210002, China
| | - Guangyi Wang
- Burn Institute of PLA, Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China
| | - Jiangning Wang
- Department of Orthopedic Surgery, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Road, Haidian District, Beijing, 100038, China
| | - Xin Wang
- Department of Plastic and Hand Surgery, Ningbo No. 6 Hospital, No. 1059 East Zhongshan Road, YinZhou District, Ningbo, 315040, China
| | - Bing Wen
- Plastic and Burn Surgery Department, Diabetic Foot Prevention and Treatment Center, Peking University First Hospital, No.8, Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Jun Wu
- Department of Burn and Plastic Surgery, Second People's Hospital of Shenzhen, Shenzhen University, No. 3002 West Sungang Road, Futian District, Shenzhen, 518037, China
| | - Hailin Xu
- Department of Orthopedics and Trauma, Peking University People's Hospital, Peking University, No.11 Xizhimen South Street, Beijing, 100044, China.,Diabetic Foot Treatment Center, Peking University People's hospital, Peking University, No.11 Xizhimen South Street, Beijing, 100044, China
| | - Maojin Xu
- Burn Institute of PLA, Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China
| | - Xiaofei Ye
- Burn Institute of PLA, Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China
| | - Liangxi Yuan
- Burn Institute of PLA, Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China
| | - Yi Zhang
- Department of Burn and Plastic Surgery, Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong, 226001, China
| | - Shichu Xiao
- Burn Institute of PLA, Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China
| | - Zhaofan Xia
- Burn Institute of PLA, Department of Burns, The First Affiliated Hospital of Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai, 200433, China
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Loh ML, Goh BKL, Kong Y, Varughese G, Ng JL, Lo ZJ, Pek CH. Combination therapy of oxidised regenerated cellulose/collagen/silver dressings with negative pressure wound therapy for coverage of exposed critical structures in complex lower-extremity wounds. Int Wound J 2020; 17:1356-1365. [PMID: 32447838 DOI: 10.1111/iwj.13406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 05/05/2020] [Indexed: 01/17/2023] Open
Abstract
Complex wounds with exposed critical structures such as tendon and bone are a conundrum in wound management, especially in the setting where the patient is not a suitable candidate for flap surgery. While the individual use of negative pressure wound therapy (NPWT) and oxidised regenerated cellulose (ORC)/collagen/silver (PROMOGRAN PRISMA) dressing has been described in the literature, there are little data on the efficacy of their combined use. In this study, we describe a novel technique of combining the use of NPWT and ORC/collagen/silver dressings to manage complex wound beds as an alternative management option for patients not suitable for reconstructive flap surgery. This technique was performed in a series of 37 patients with complex lower-extremity wounds that were not healing with conventional NPWT alone. All patients had open wounds with exposed critical structures that were difficult to manage, such as exposed tendon, bone, deep crevices, and joint. Successful coverage of exposed critical structures was achieved in 89% of patients, and coverage was achieved within 28 days of combination therapy in 82% of these patients, without any complications. The novel technique of combining ORC/collagen/silver dressing and NPWT provides a useful option in the armamentarium of a reconstructive surgeon dealing with difficult complex lower-extremity wounds.
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Affiliation(s)
- Mei Ling Loh
- Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Benjamin K L Goh
- Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Yuan Kong
- Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service, Khoo Teck Puat Hospital, Singapore, Singapore
| | - George Varughese
- Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Jia Lin Ng
- Department of Podiatry, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Zhiwen J Lo
- Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Chong Han Pek
- Department of General Surgery, Plastic, Reconstructive and Aesthetic Surgery Service, Khoo Teck Puat Hospital, Singapore, Singapore
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