title: The influence of different debridement methods on the prognosis of elderly patients with diabetic foot ulcers and sepsis.
abstract: BACKGROUND
  We evaluated the influence of different debridement methods on the prognosis of elderly patients with diabetic foot ulcers complicated with sepsis.
  
  
  METHODS
  Retrospective study was adopted to study 65 hospitalized elderly patients with Wagner Grade-4 diabetic foot ulcer and sepsis in Vascular Disease Department of Shanghai TCM-Integrated Hospital. Thirty-two cases were included in the thorough debridement group and the other 33 were included in the minor debridement group. We compared the mortality rates on the 7th day and 14th day after debridement, and monitored changes of sepsis-related organ failure assessment (SOFA) Score as well as C-reactive protein (CRP), procalcitonin (PCT) and D-Dimer (D-D) levels. Cox regression analysis and Kaplan-Meier analysis were used to analyze the mortality rates. Binary logistic regression analysis was employed to screen relevant prognostic factors to see the prognostic value of SOFA Score, PCT and D-D.
  
  
  RESULTS
  Fatality rates of the thorough debridement group on the 7th day and 14th day of the debridement were higher than those in the minor debridement group and such a difference has statistical significance. The CRP, PCT, and D-D of patients within seven days after thorough debridement were obviously higher than those of patients after minor debridement.
  
  
  CONCLUSIONS
  Damage control should be provided for elderly patients with diabetic foot ulcers and sepsis when debridement is being performed. Palliative debridement methods such as small-scale incision and drainage are less likely to affect systematic inflammatory response and coagulation function, and thus can buy time for further treatment to improve clinical effect.
authors.affiliation: Angiopathy Department, Shanghai University of TCM, Shanghai TCM-Integrated Hospital, Shanghai, China.
authors.forename: Qintong
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Angiopathy Department, Shanghai University of TCM, Shanghai TCM-Integrated Hospital, Shanghai, China - cao_yemin1@163.com.
authors.forename: Yemin
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Angiopathy Department, Shanghai University of TCM, Shanghai TCM-Integrated Hospital, Shanghai, China.
authors.forename: Yudong
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Angiopathy Department, Shanghai University of TCM, Shanghai TCM-Integrated Hospital, Shanghai, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.affiliation: Endocrine Department, Shanghai University of TCM, Shanghai TCM-Integrated Hospital, Shanghai, China.
authors.forename: Puqing
authors.initials: P
authors.lastname: Zhao
authors.affiliation: Clinical Laboratory, Shanghai University of TCM, Shanghai TCM-Integrated Hospital, Shanghai, China.
authors.forename: Weiling
authors.initials: W
authors.lastname: Wang
authors.affiliation: Angiopathy Department, Shanghai University of TCM, Shanghai TCM-Integrated Hospital, Shanghai, China.
authors.forename: Lingfeng
authors.initials: L
authors.lastname: Yin
authors.affiliation: Angiopathy Department, Shanghai University of TCM, Shanghai TCM-Integrated Hospital, Shanghai, China.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Xu
authors.affiliation: Surgical Department, Shanghai University of TCM, Shanghai TCM-Integrated Hospital, Shanghai, China.
authors.forename: Gaowu
authors.initials: G
authors.lastname: Hu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016470:Bacteremia / Q000150:complications / Q000401:mortality / Q000601:surgery*; D002681:China; D003646:Debridement / Q000379:methods; D017719:Diabetic Foot / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome