Diabetic foot is one of the serious complications of diabetic patients. It is caused by diabetes combined with different degrees of lower extremity vascular lesions and neuropathy, and the wound can not heal for a long time. The serious results can cause bone marrow infection, bone destruction, and have high disability and death rate. At present, there are various treatment methods for diabetic foot chronic wound. On the basis of internal medicine controlling blood sugar, anti infection, lowering blood lipid, improving microcirculation and nourishment nerve, the surgical method is adopted, including the debridement of the necrosis in a short time to prevent the infection from spreading; maggot biological debridement and ozone chemical debridement will promote the growth of granulation tissue while controlling infection. Skin grafting, skin flap transplantation, skin distraction closure can be used to repair soft tissue defects, or fat transplantation, platelet-rich plasma, and rich blood are used for the refractory wound after infection control. In patients with diabetic foot, the reconstruction of lower limb blood supply is beneficial to the recovery of chronic ischemic wounds. It is feasible to improve the blood supply of the lower extremities, improve the blood supply of the lower extremity artery bypass grafting, and improve the microcirculation of the peripheral vessels around the lower extremities. Lower extremity vascular bypass pressure perfusion therapy for vascular network expansion, tibia lateral moving technique for lower limb microcirculation reconstruction. For diabetic foot ulcer caused by peripheral neuropathy, such as Charcot foot, while the application of external fixator, total contact cast technology of affected foot for reducing treatment to promote wound healing; the preparation of orthopedic shoes can play a maximum protective effect on the healing of diabetic foot wound healing.
糖尿病足是糖尿病患者严重并发症之一，由糖尿病合并不同程度的下肢血管及神经病变而引起足部改变，形成的创面可经久不愈，严重者可导致骨髓感染、骨质破坏，具有较高的致残、致死率。目前对于糖尿病足慢性创面的治疗方法多种多样，均是在内科控制血糖、抗感染、降血脂、改善微循坏、营养神经基础上，采取外科方法治疗，包括对于严重感染的慢性创面采取短时间内坏死组织清创，防止感染扩散致使下肢感染平面上移；蛆虫生物清创技术及臭氧化学清创技术将在控制感染的同时促进肉芽组织生长；针对感染控制后的难愈合创面采取植皮、皮瓣移植、皮肤牵张闭合器修复软组织缺损，或者应用脂肪移植、富血小板血浆及富血小板纤维蛋白等进行组织修复。针对下肢血管病变的糖尿病足患者，重建下肢血供有利于慢性缺血创面恢复，可行介入治疗改善患者下肢血供，下肢动脉旁路移植改善血供，腰交感神经节毁损术改善下肢周围血管微循环灌注，下肢血管体外循环加压灌注疗法进行血管网扩增，胫骨横向搬移技术行下肢微循环重建；对于糖尿病足周围神经病变形成的溃疡创面，如夏克足，则应用外固定架技术、全接触石膏技术行患足减负治疗以促进愈合；矫形鞋具的制备对于糖尿病足创面愈合后复发可以起到最大限度的保护作用。.
Keywords: Diabetic foot; chronic wound; complex treatment.