Abstract:

BACKGROUND: In the clinic, it was found that the flap survived difficultly after the diabetic foot using skin flap, whether random-pattern flap or axial pattern skin flaps are difficult to maintain a good blood supply. And it is difficult to heal where the flap for the formation to be a new wound. Transfer of local skin flap can induce poor blood supply and flap necrosis.
OBJECTIVE: To explore clinical effects of autologous free skin graft transplantation in treatment of diabetic foot ulcer.
METHODS: A total of 102 patients (57 males and 45 females) with diabetic foot ulcer were treated, with an average age of 54.5 years (35-83 years). The disease course of diabetes was 3 months to 23 years (12 years on average) and the disease course of diabetic foot was 20 days to 2.5 years (7 months on average). Before skin grafting, the patients were treated with general treatment, including insulin, antibiotics. Serial wound surface managements were achieved. When new layers of granulation tissues were formed over the wounds, the split skin grafts were transplanted. According to wound location, size, with the humby knife or drum dermatome to take skin from autologous donor site to graft skin with packaging method or stamp-like skin grafting. Affected limb was fixed using plaster slab. And pressure bandage with sterile pad to be ensure skin graft in close contact with the granulation wound.
RESULTS AND CONCLUSION: 102 patients carried out the first partial debridement, later-stage used skin grafting. None of skin graft area formed a new ulcer because of severe wound infection or the undesirable growth. Of them, 83 cases of skin grafts survived well after the skin graft, and following wound healing they was discharged. 19 cases of skin graft survival were poor, and controlled through the dressing or replanted quickly, and then discharged, with a mean process of (21±7) days. A total of 89 cases were followed up for 15 months averagely (ranged from 3 months to 3.5 years). Eight patients developed new ulcers, with 3 lesions in situ and 5 lesions in new site. Other patients can stand or walk by themselves or with a cane. These indicated that autologous free skin graft is an effective method in treating diabetic foot ulcer.