[Clinical application of nose ring drain in severe diabetic foot infection]

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Aug 15;34(8):990-993. doi: 10.7507/1002-1892.202003190.
[Article in Chinese]


Objective: To evaluate the effectiveness of the nose ring drain (NRD) in treatment of severe diabetic foot infection.

Methods: The clinical data of 35 patients with severe diabetic foot infection who were treated with NRD between June 2017 and June 2019 were analyzed retrospectively. There were 24 males and 11 females with an average age of 54.5 years (range, 28-82 years). All of them were type 2 diabetic patients. The diabetes duration was 3-20 years, with an average of 9.4 years. The diabetic foot duration was 4 months to 2 years, with an average of 1.16 years. There were 16 cases of left foot and 19 cases of right foot. According to Wagner's grading, there were 11 cases of grade 2, 20 cases of grade 3, and 4 cases of grade 4, all of which were moderate and severe infection of diabetic foot wound. Postoperative wounds were treated with "nibble-like" debridement until the patient's epidermis regenerated and healed. During the treatment process, the indexes of bacterial culture type of wound secretions, duration of antibiotic therapy, wound healing method, healing time, amputation rate, and other indicators were analyzed and summarized.

Results: All 35 patients were followed up 3-6 months, with an average of 4.5 months. Postoperative bacterial culture of wounds showed that 5 cases of Staphylococcus aureus, 4 cases of Pseudomonas aeruginosa, 5 cases of Escherichia coli, 3 cases of Enterobacter cloacae, 3 cases of coagulase-negative Staphylococcus, and 15 cases of other types were detected. The duration of antibiotic therapy ranged from 3 to 15 days, with an average of 9.1 days. The wound was autolytically healed without skin grafting, and the healing time was 62-82 days, with an average of 72.3 days. During the follow-up, 3 cases (8.6%) had amputation due to the patient's poor blood glucose control, which led to a large spread of infection. In addition, among the other patients with wound healing, there was no recurrence of wound infection or new ulcer on the original surface.

Conclusion: The NRD is a simple operation for treatment of severe diabetic foot infection, which can effectively control wound infections and promote wound healing and regeneration without skin grafting.

目的: 探讨牛鼻子引流术(nose ring drain,NRD)治疗严重糖尿病足感染创面的临床效果。.

方法: 回顾分析 2017 年 6 月—2019 年 6 月采用 NRD 治疗的 35 例严重糖尿病足感染创面患者临床资料。男 24 例,女 11 例;年龄 28~82 岁,平均 54.5 岁。均为 2 型糖尿病患者,糖尿病病程 3~20 年,平均 9.4 年。糖尿病足病程 4 个月~2 年,平均 1.16 年。左足 16 例,右足 19 例。根据 Wagner 分级:2 级 11 例,3 级 20 例,4 级 4 例;均为糖尿病足创面中重度感染。术后创面采用“蚕食样”持续清创至表皮再生愈合。治疗过程中分析并总结创面分泌物细菌培养类型、临床抗生素使用时间,创面愈合方式、愈合时间、截肢比例等指标。.

结果: 35 例患者均随访,随访时间 3~6 个月,平均 4.5 个月。术后创面细菌培养结果显示,金黄色葡萄球菌 5 例、铜绿假单胞菌 4 例、大肠埃希菌 5 例、阴沟肠杆菌 3 例、凝固酶阴性葡萄球菌 3 例,其他类型 15 例。临床抗生素使用时间 3~15 d,平均 9.1 d。创面自溶性愈合,无需植皮,创面愈合时间 62~82 d,平均 72.3 d;随访过程中 3 例(8.6%)患者因血糖控制不佳,感染大面积扩散导致截肢 。创面愈合患者原创面处未出现感染复发及新生溃疡。.

结论: 应用 NRD 治疗严重糖尿病足感染创面,能有效控制创面感染,促进创面再生愈合,无需植皮且操作简便。.

Keywords: Diabetic foot; nose ring drain; wound infection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical
  • Diabetes Mellitus*
  • Diabetic Foot*
  • Drainage
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Wound Healing