(DLS-029) Successful application of extracorporeal circulation compression perfusion in the treatment of diabetic foot: a retrospective cross-sectional study

Tianbo Li, Doctor; Jiangning Wang, Doctor – Hospital President, Orthopedic Department, Capital Medical University Affiliated Beijing Shijitan Hospital

Introduction: Severe limb ischemia caused by peripheral artery disease remains a major unresolved public health problem.10 Although endovascular and open surgical techniques have progressed in the treatment of severe limb ischemia, there are still a large number of patients who cannot undergo revascularization owing to the distal range of the disease, absence of autogenous catheters, or related complications. These patients have a poor quality of life and often must undergo amputation.Extracorporeal Circulation Compression Perfusion (ECCP)was associated with improved foot microcirculatory perfusion. ECCP has clinical practicality by accelerating wound healing and reducing the ulcer recurrence rate.

Methods: We retrospectively evaluated 89 patients with diabetic foot admitted from January 2017 to April 2019. The patients were grouped according to whether they received ECCP treatment; experimental group: 27 patients, controls: 62 patients. After applying the inclusion criteria and exclusion criteria, there were 21 patients in the experimental group and 21 patients in the control group. Foot microcirculation was evaluated by measuring the percutaneous oxygen partial pressure (TcPO2) and infrared thermography (IRT). Wound healing time and ulcer recurrence rate 1 year after discharge were compared between the groups.

Results: TcPO2 and IRT values in the experimental group differed significantly compared with the control group. Foot ulcer healing time in the experimental group was shorter than that in the control group (17.10 ± 3.08 days vs 25.38 ± 4.40 days, respectively), and the recurrence rate after 1 year in the experimental group was lower than that in the control group (2/21, 9.5% vs

9/21, 42.8%, respectively).

Discussion: With ECCP for circulatory perfusion of ischemic diseased limbs, the stenosis site of diseased blood vessels expanded, and blood flow through the cross section of blood vessels increased per unit time. The tissue blood supply increased, and reconstruction of the peripheral vascular network was promoted during perfusion. This technique can reconstruct lower limb microcirculation in diabetic foot, promote wound healing, effectively delay the progression of diabetic peripheral vascular disease, and reduce the disability rate of diabetic foot.