부산대학교 도서관

Aim: Charcot neuroarthropathy leads to deformity and chronic ulceration, reconstructive surgery offers the potential of limb salvage. Wound complications following limb surgery in diabetes can be problematic as rapid predictable healing is required to prevent bacterial colonisation, infection that can lead to failure. A comparative assessment of standard treatment with and without TLC-NOSF dressings as part of a in service quality improvement study in the management of post-surgical wound dehiscence/ breakdown following diabetic foot surgery. Method: All patients with diabetes undergoing staged CN reconstruction with documented PAD, presenting with wound dehiscence or breakdown or reduced healing were included. Patients underwent standard treatment routine office-based debridement with standard dressings and total contact casting. From Aug 2021 4pts were also treated with a TLC-NOSF dressing was applied. All patients were prospectively followed up, to primarily assess wound healing, the time to complete healing, and secondarily treatment complications. Results / Discussion: Fifteen patients were identified from May 2014 - August 2022 in a specialized diabetic foot unit undertaking limb preservation surgery. The overall time to healing was 16.8weeks, and the mean lesion size was 2.3cm2, we observed the speed of healing improved with TLC-NOSF dressing from 0.11cm2/week (n=11) to 0.14cm2/week (n=4), leading to a possible reduction in healing time of 2 weeks for every 1cm2. No patient required revascularisation during follow-up, but all were treated with bacterial specific antibiotics until wound healing. Conclusion: Early results suggest, wound healing can be improved using TLC-NOSF dressings, allowing timely resolution of wound dehiscence for cost effective care.