关键词: 抗生素骨水泥, 　糖尿病足, 　骨髓炎, 　万古霉素, 　负压封闭引流技术

Abstract: Objective　To evaluate the efficacy of vancomycin bone cement combined with other comprehensive interventions in the treatment of diabetic foot osteomyelitis (DFO). Methods　A retrospective analysis of 93 patients with DFO (112 affected feet) who received vancomycin bone cement combined with other interventions was performed. Duration of oral and intravenous antibiotic use, length of hospital stay, ulcer healing time, recurrence rates, and amputation rates above the ankle were assessed at the last follow-up. Bacterial culture of secretion from deep wound surface of foot ulcer was conducted. Recovery of foot function was assessed using the Maryland standard. Results　Eighty-seven patients with 105 involved feet were followed up successfully over an average period of 14 months. All wounds exhibited good union on follow up, and DFO was cured. The average durations of oral and intravenous antibiotic administrations were （12.2±1.5） and （10.8±2.5） days, respectively. The average duration of hospitalization was 14.0±2.7 days and the healing time of the ulcers was （37.8±6.3） days. Twenty-one patients (21 feet) were re-hospitalized after recurrence of foot ulcers, with a recurrence rate of 20% (21/105). No patients required amputation above the ankle. One hundred and forty-four pathogenic bacteria were co-cultured from the secretions of deep wounds from foot ulcers. According to the Maryland criteria, 31, 45, 26, and 3 feet were rated as excellent, good, fair, and failure, respectively. Overall, 72% were rated as excellent-good. Conclusion　Antibiotic bone cement combined with other comprehensive interventions is effective and comprehensive in the treatment ofDFO, which is worthy of clinical application.

Key words: Antibiotic bone cement, 　Diabetic foot, 　Osteomyelitis, 　Vancomycin, 　Vacuum sealing drainage