负压引流联合银离子水凝胶敷料治疗2型糖尿病下肢皮肤慢性感染创面OACSTPCD

Objective To investigate the effect of negative pressure wound therapy combined with silver ionized hydrogel on wound healing in type 2 diabetic patients with chronic skin infections in the lower extremities.Methods Ninety-nine patients with chronic infected wounds in the lower limb skin of type 2 diabetes admitted to the author's hospital from April 2020 to May 2022 were selected for the study.They were divided into group A,group B and group C with 33 cases in each group by random number table method.Group A received silver ionized hydrogel,group B received negative pressure wound treatment,and group C received negative pressure wound treatment combined with silver ionized hydrogel.The wound healing time,granulation tissue formation time,and epithelial tissue formation time of the three groups were counted.The pain score of the three groups before treatment,7 days and 14 days after treatment were compared.The levels of vascular endothelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9),tissue metalloproteinase-1(TIMP-1)and serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),Superoxide dismutase(SOD),malondialdehyde(MDA),and advanced oxidation protein products(AOPP)in wound exhalation were compared between the three groups before treatment and 7 days after treatment.Results The wound healing time,granulation tissue formation time,and epithelial tissue formation time of the three groups were combined group＜negative pressure drainage group＜dressing group(P＜0.05).On treatment day 7 and 14,the VAS scores of the three groups were all lower than those of combined group＜negative pressure drainage group＜dressing group(P＜0.05).After 7 days of treatment,the levels of VEGF and TIMP-1 in the three groups were higher than those before treatment,and the combined group＞negative pressure drainage group＞dressing group,and the level of MMP-9 was lower than that before treatment,and the combined group＜negative pressure drainage group＜dressing group(P＜0.05).On the 7th day of treatment,the serum levels of IL-8,TNF-α,and IL-6 in the combination group were lower than those in the negative pressure drainage group and the dressing group(P＜0.05).On treatment day 7,the SOD level in the combined group was higher than that in the negative pressure drainage group and dressing group,and the MDA and AOPP levels were lower than those in the negative pressure drainage group and dressing group(P＜0.05).Conclusion Negative pressure wound treatment combined with silver ionized hydrogel can reduce the content of MMP-9,increase the content of VEGF and TIMP-1,reduce inflammatory response and oxidative stress response,and help promote wound healing and alleviate pain in patients with type 2 diabetes with chronic infected wounds of lower limb skin.