Application of antibiotic cement combined with propeller flap in the repair of diabetic foot and ankle wound
DUAN Jia-zhang
HE Xiao-qing
XU Yong-qing
WANG Teng
YU Kai-fu
FENG Fan-zhe
LUO Hao-tian
YANG Xi
LI Guo-dong
Abstract：Objective To investigate the clinical application value of antibiotic cement combined with pro-peller flap in the repair of diabetic foot and ankle wounds .Methods From Sep.2013 to Dec.2015,9 diabetic pa-tients with foot and ankle wounds who were treated by vancomycin cement or tobramycin cement combined with pero -neal artery perforator or posterior tibial artery propeller flap were reviewed retrospectively .There were 6 males and 3 females,with an average age of 53.1 years (range,45 to 63 years).The causes included traffic accident injury in 5 cases,heavy crush injury in 2 cases,machine injury in 1 case and falling injury in 1 case.Among all the cases,the wound secretion bacterial culture was positive in 7 cases,and the defect area ranged from 4.5 cm ×4.0 cm to 8.0 cm ×6.5cm.Before operation,the blood sugar was controlled within 7mmol/L when limosis,and within 11mmol/L at two hours after meal .A sufficient amount of sensitive antibiotics was used to prevent infection .After peripheral e-dema dissipating ,hand-held Doppler ultrasound was used to locate the perforators and complete propeller flap de -sign.Through debridement during the operation , preoperative design guided the flap harvest and flap rotation re-paired the wound .In the serious infection areas under the flap ,1-2 vancomycin cement bars were placed ,and pulled out after 2-3 weeks.The size of flaps varied from 13.0 cm ×5.0 cm to 23.0cm ×9.0cm.The donor sites in 4 ca-ses were directly sutured ,and the donor sites of 5 cases were repaired by skin graft .Results During the operation , the flaps were successfully harvested and the wounds were repaired .All flaps survived smoothly ,among which 2 cases had distal flap necrosis but healed after changing dressing .The donor sites were healed by first intention .All cases were followed up from 6 months to 21 months (mean,11.1 months).All flaps had good shape.Conclusion Antibi-otic cement combined with propeller flap is an effective way in the repair of diabetic foot and ankle wounds .
Keywords：foot and ankle wounddiabetesantibioticsbone cementflaprepair
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 809-813 )