Clinical effects of antibiotic bone cement combined with free anterolateral thigh flap in sequential treatment of diabetic foot ulcer

Chen Wei; Chang Shusen; Zhou Jian; Zhang Fang; Yang Chenglan; Nie Kaiyu; Deng Chengliang; Wei Zairong

doi:10.3760/cma.j.cn501225-20220628-00267

Volume 39 Issue 4

Apr. 2023

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2023 > 39(4): 319-324

Chen W,Chang SS,Zhou J,et al.Clinical effects of antibiotic bone cement combined with free anterolateral thigh flap in sequential treatment of diabetic foot ulcer[J].Chin J Burns Wounds,2023,39(4):319-324.DOI: 10.3760/cma.j.cn501225-20220628-00267.

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Clinical effects of antibiotic bone cement combined with free anterolateral thigh flap in sequential treatment of diabetic foot ulcer

doi: 10.3760/cma.j.cn501225-20220628-00267

Department of Burns and Plastic Surgery, the Affiliated Hospital of Zunyi Medical University, Zunyi 563003, China

Funds:

Science and Technology Plan Project of Guizhou Province of China 2020-5012

Collaborative Innovation Center of Chinese Ministry of Education 2020-39

Science and Technology Plan Project of Zunyi City 2021-3

Regional Science Foundation Program of National Natural Science Foundation of China 81760347

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Corresponding author: Wei Zairong, Email: zairongwei@163.com
Received Date: 2022-06-28

Abstract

Abstract

Objective To investigate the clinical effects of antibiotic bone cement combined with free anterolateral thigh flap in sequential treatment of diabetic foot ulcer (DFU) wounds. Methods A retrospective observational study was conducted. From August 2018 to August 2021, 15 patients with DFU who met the inclusion criteria were admitted to the Affiliated Hospital of Zunyi Medical University, including 12 males and 3 females, aged 42-65 years, with a history of type 2 diabetes for 5-19 years. All the wounds of patients were complicated with local bone, muscle, or tendon defects or exposure. The wounds were covered with antibiotic bone cement after debridement in stage Ⅰ+free anterolateral thigh chimeric perforator flap (perforator flap+muscle flap) or simple free anterolateral thigh flap grafting in stage Ⅱ. The defect area of the wound after bone cement removal and debridement was 9.0 cm×5.0 cm-20.0 cm×7.0 cm, the incision area of the flap was 10.0 cm×5.0 cm-22.0 cm×7.0 cm, and the incision area of the muscle flap was 5.0 cm×3.0 cm-8.0 cm×4.0 cm. The donor sites of flaps were sutured directly. During follow-up, the situations of donor site healing and flap survival were observed. At the last follow-up, the texture and shape of the flap, the presence of new ulcers on both limbs, and the walking ability of the patient were observed. Results During the follow-up of 8 to 21 months after operation in stage Ⅱ, the donor sites healed well with only residual linear scar; flaps in 14 patients survived completely, and the flap in 1 patient developed partial necrosis at 3 weeks after stage Ⅱ surgery, which was healed after debridement and skin grafting. At the last follow-up, the flaps were good in texture and appearance, there were no new ulcers in the affected limb or opposite limb, and the patients had no obvious impairment in daily walking function. Conclusions To repair DFU wounds with antibiotic bone cement combined with free anterolateral thigh flap can rapidly control the infection, achieving a high survival rate of flap after operation with no obvious impairment in daily walking function of patients.
- Diabetic foot,
- Perforator flap,
- Ulcer,
- Microsurgery,
- Bone cement,
- Limb salvage

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References

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