Combining antibiotic‐loaded bone cement‐based free vastus lateralis muscle‐sparing flap with split‐thickness skin grafts: A reliable strategy for reconstructing diabetic foot ulcers at non‐weight‐bearing areas

• DOI: 10.1111/iwj.14900
• Publication Date: 2024-05-06T01:35:40Z
• Authors: Shusen Chang; Yang Jian; Chenxiaoxiao Liu; Ilaria Dal Prà; Ubaldo Armato; Xin Chen; Jian Zhou; Wei Chen; Fang Zhang; Kaiyu Nie; Daniele De Santis; Chengliang Deng; Zairong Wei
• Keywords: Debridement (dental)

Abstract Diabetic foot ulcers (DFUs) present significant challenges due to their associated amputation rates, mortality, treatment complexity and excessive costs. Our earlier work introduced a wound surgical integrated (WSIT) for DFUs, yielding promising outcomes. This study focuses on specific WSIT protocol employing antibiotic‐loaded bone cement (ALBC) in the first Stage, free vastus lateralis muscle‐sparing (VLMS) flaps split‐thickness skin grafts (STSGs) second stage repair non‐weight‐bearing DFUs. From July 2021 2023, seven DFU patients (aged 47–71 years) underwent this treatment. Demographic data, hospital stay surgery times were collected. Histological immunohistochemical analyses assessed angiogenesis, collagen deposition inflammation. SF‐36 questionnaire measured pre‐ postoperative quality of life. Preoperative ultrasound Doppler showed that peak blood flow velocity recipient area artery was significantly >30 cm/s (38.6 ± 6.8 cm/s) all patients. Muscle flap sizes varied from 8 × 3.5 1 18 6 2 cm. The operation time 156.9 15.08 minutes, 18.9 3.3 days. analysis proved covering DFUs with ALBC induced membrane formation increased collagen, neovascularization M2 macrophages fraction while reducing M1 one. All survived without during 7‐ 24‐month follow‐up, which scores improved. A combination VLMS STSGs be safe effective reconstructing It rapidly controlled infection, enhanced life function, reduced hospitalization time. We advocate integrating strategy into plans.