A Randomized Controlled Trial of Shengji Ointment Combined with Bromelain in Promoting Healing of Tendon-Exposed Diabetic Foot Wounds: 16S rDNA Sequencing Analysis
Background: Diabetic foot tendon exposures are prone to infection, necrosis, and prolonged treatment cycles, which hinder wound healing and may lead to amputation or life-threatening complications. Shengji ointment combined with bromelain has shown potential in early clinical use, but its impact on wound microbiota remains unclear.Methods: Thirty patients with diabetic foot tendon-exposed wounds were prospectively evaluated in this treatment study. All patients received four-week treatment with Shengji ointment combined with bromelain. Granulation tissue coverage and wound healing rates were assessed before and after treatment. Wound exudates were collected at baseline and post-treatment for 16S rDNA sequencing to analyze changes in microbial composition.Results: After treatment, granulation tissue coverage and wound healing rates significantly improved. Microbial profiling showed a marked shift in wound microbiota, with decreased potential pathogens (Erysipelatoclostridium, Lachnoclostridium, Pontimonas, Hydrogenovibrio, Aquabacterium) and increased beneficial bacteria (Cetobacterium, Allisonella).Conclusion: Shengji ointment combined with bromelain promotes healing in diabetic foot tendon-exposed wounds by restructuring wound microbiota, suppressing harmful bacteria and enriching beneficial species. These findings provide mechanistic insights and support further clinical exploration of this treatment.