피부이식술을 통한 만성 당뇨족 창상 치료의 효용성

• Published in: 대한족부족관절학회지 Vol. 26; no. 2; pp. 78 - 83
• Main Authors: 김윤정, 김보성, 정호원, 안재훈, Kim, Yoon-Chung, Kim, Bo-Seoung, Jeong, Howon, Ahn, Jae Hoon
• Format: Journal Article
• Language: Korean
• Published: 대한족부족관절학회 01.06.2022
• Subjects: 정형외과학; Acellular dermal matrix; Chronic diabetic wound; Negative-pressure wound therapy; Skin graft
• ISSN: 1738-3757; 2288-8551
• DOI: 10.14193/jkfas.2022.26.2.78

Purpose: The purpose of this study was to evaluate the surgical outcome of split-thickness skin graft (STSG) for chronic diabetic wounds of the foot and ankle. Materials and Methods: The medical records of 20 patients who underwent surgery for chronic diabetic wounds of the foot and ankle between October 2013 and May 2018 were reviewed. Surgical management consisted of consecutive debridement, followed by negative-pressure wound therapy and STSG. We used an acellular dermal matrix between the wound and the overlying STSG in some patients with wide or uneven wounds. Patient satisfaction, comorbidities, wound size and location, length of hospital stay, wound healing time, and complications were investigated. Results: Of 20 patients, 17 (85.0%) were satisfied with the surgical outcome. Eight patients had diabetic wounds associated with peripheral vascular disease (PVD), 7 patients had diabetic wounds without PVD, and 5 patients had acute infection superimposed with necrotizing abscesses. The mean size of the wound was 49.6 cm2. The mean length of hospital stay was 33.3 days. The mean time to wound healing was 7.9 weeks. The mean follow-up period was 25.9 months. Complications included delayed wound healing (4 cases) and recurrence of the diabetic wounds (2 cases), which were resolved by meticulous wound dressing. Conclusion: STSG remains a good treatment strategy for chronic diabetic wounds of the foot and ankle.