Objective To explore the repair method for refractory diabetic wound. Methods We conducted a retrospective cohort study of a total of 113 patients( 2005. 8 -2010. 11 )with refractory diabetic foot ulcers treated with proper surgical treatments. Results Of all patients,83 were treated by autolo-gous free skin graft( 73. 45% ),with one stage wound healing rate of 81. 92% ; 27 were repaired with skin flap( 23. 89% ), with survival rate of the flap of 85. 19% ; 30( 41 toes )underwent simple toe amputation; 3 underwent amputation. In total of 86 patients were followed up for 6 months ~ 4. 5 years( averaging 17 months ),which showed that ulcer recurred in 7 patients( 8. 14% ). Conclusion Flap and skin graft repair could effectively shorten ulcer healing time and promote the quality of life.%目的 探讨糖尿病溃疡难愈创面修复方法.方法 回顾性分析我科2005年8月至2010年11月期间113例(122条患肢)糖尿病足患者的临床资料.113例糖尿病足部溃疡应用自体游离皮片移植83例(73.45%);局部皮瓣修复者27例( 23.89%);30例行单纯足趾截除41趾;3例行截肢术.结果 自体游离皮片移植成活率为81.92%,局部皮瓣修复Ⅰ期愈合率为85.19%.86例获得6个月～4.5年的随访,平均17个月,7例溃疡复发,复发率8.14%,其余创面愈合良好.结论 采用皮瓣和皮片移植修复创面,可缩短溃疡愈合时间,提高患者生活质量.
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