Therapeutic effect of platelet-rich plasma combined with vacuum sealing drainage on diabetic foot patients and the risk factors of poor wound healing

Objective To investigate the therapeutic effect of platelet-rich plasma (PRP) combined with vacuum sealing drainage (VSD) on patients with diabetic foot (DF) and to analyze the risk factors of poor wound healing.Methods A total of 110 DF patients who were admitted to Subei People's Hospital of Jiangsu province from June 2022 to June 2023 were selected. According to the treatment methods, they were divided into two groups (n=55): a control group receiving conventional therapy combined with VSD and an observation group receiving PRP in addition to the therapies in the control group. After four-week treatment, both groups were compared for the clinical efficacy, the lesion symptom score, and adorsalis pedis artery index (blood flow, lumen diameter, and pulsatility index). According to the wound healing after four-week treatment, the patients were divided into a good wound healing group, and a poor wound healing group. The relationship between various factors and poor wound healing in DF patients was analyzed by bivariate logistic regression.Results After four-week treatment, the observation group showed a higher total effective rate than the control group (P＜0.05). Compared with those before treatment, both groups showed reduced lesion symptom scores after treatment, where higher scores were found in the observation group than the control group (P＜0.05). Meanwhile, the blood flow, lumen diameter and pulsatility index decreased in the two groups, compared with those before treatment, and higher values were found in the observation group (P＜0.05). The poor wound healing group presented increases in the ulcer area and fasting blood glucose (FBG) level at admission, as well as decreases in the proportions of patients with Wangner grade III, malnutrition and smoking, compared with the good wound healing group (P＜0.05). Large ulcer area, high FBG level at admission, malnutrition and smoking were risk factors for poor wound healing in DF patients (P＜0.05).Conclusions PRP combined with VSD can effectively improve the clinical symptoms of DF patients, promote wound healing, and improve foot blood flow. Meanwhile, ulcer area, FBG level at admission, nutritional status and smoking are related to poor wound healing in DF patients.