Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2024; 12(17): 2976-2982
Published online Jun 16, 2024. doi: 10.12998/wjcc.v12.i17.2976
Clinical comprehensive treatment protocol for managing diabetic foot ulcers: A retrospective cohort study
Yan-Bin Wang, Yan Lv, Guang-Yu Li, Ji-Ting Zheng, Qing-Xin Jiang, Ran Wei
Yan-Bin Wang, Guang-Yu Li, Ji-Ting Zheng, Department of Vascular Surgery, Harbin 242 Hospital, Harbin 150066, Heilongjiang Province, China
Yan Lv, Qing-Xin Jiang, Ran Wei, First Department of General Surgery, Harbin 242 Hospital, Harbin 150066, Heilongjiang Province, China
Author contributions: Wang YB was the guarantor and designed the study; Lv Y and Li GY participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Zheng JT, Jiang QX, Wei R revised the article critically for important intellectual content; all authors participated in this study and jointly reviewed and edited the manuscript.
Supported by General Medical Research Fund Project, No. TYYLKYJJ-2022-021.
Institutional review board statement: The research plan was reviewed and approved by Harbin 242 medical ethics committee of our hospital.
Informed consent statement: The requirement for informed consent was waived owing to the retrospective nature of the study.
Conflict-of-interest statement: Dr. Wang has nothing to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Bin Wang, Associate Chief Physician, Department of Vascular Surgery, Harbin 242 Hospital, No. 3 Weijian street, Pingfang District, Harbin, Harbin 150066, Heilongjiang Province, China. wyb1376010705@163.com
Received: March 7, 2024
Revised: April 22, 2024
Accepted: April 23, 2024
Published online: June 16, 2024
Processing time: 89 Days and 7.4 Hours
Abstract
BACKGROUND

Diabetic foot ulcers (DFUs) are a common complication of diabetes, often leading to severe infections, amputations, and reduced quality of life. The current standard treatment protocols for DFUs have limitations in promoting efficient wound healing and preventing complications. A comprehensive treatment approach targeting multiple aspects of wound care may offer improved outcomes for patients with DFUs. The hypothesis of this study is that a comprehensive treatment protocol for DFUs will result in faster wound healing, reduced amputation rates, and improved overall patient outcomes compared to standard treatment protocols.

AIM

To compare the efficacy and safety of a comprehensive treatment protocol for DFUs with those of the standard treatment protocol.

METHODS

This retrospective study included 62 patients with DFUs, enrolled between January 2022 and January 2024, randomly assigned to the experimental (n = 32) or control (n = 30) group. The experimental group received a comprehensive treatment comprising blood circulation improvement, debridement, vacuum sealing drainage, recombinant human epidermal growth factor and anti-inflammatory dressing, and skin grafting. The control group received standard treatment, which included wound cleaning and dressing, antibiotics administration, and surgical debridement or amputation, if necessary. Time taken to reduce the white blood cell count, number of dressing changes, wound healing rate and time, and amputation rate were assessed.

RESULTS

The experimental group exhibited significantly better outcomes than those of the control group in terms of the wound healing rate, wound healing time, and amputation rate. Additionally, the comprehensive treatment protocol was safe and well tolerated by the patients.

CONCLUSION

Comprehensive treatment for DFUs is more effective than standard treatment, promoting granulation tissue growth, shortening hospitalization time, reducing pain and amputation rate, improving wound healing, and enhancing quality of life.

Keywords: Diabetic foot ulcers; Comprehensive treatment protocol; Clinical study; White blood cell count; Wound healing; Amputation rate

Core Tip: That a comprehensive treatment protocol for diabetic foot ulcers (DFUs) yields superior outcomes compared to standard treatment. The protocol involving interventions for improving blood circulation, debridement, vacuum-sealing drainage, growth factor dressing, and skin grafting, resulted in faster wound healing, reduced amputation rates, and enhanced quality of life. These findings underscore the importance of implementing a comprehensive treatment approach to DFU management to promote granulation tissue growth, shorten hospital stays, alleviate pain, and improve wound healing. In this study, patients who received comprehensive treatment experienced significantly better wound healing rates, shorter healing times, and lower amputation rates than those of patients who received standard treatment.