Abstract: Objective To explore the clinical efficacy of tibial transverse transport （TTT） combined with collagenase in the treatment of refractory diabetic foot ulcers. Methods  A retrospective analysis was conducted on 40 patients with refractory diabetic foot ulcers who met the inclusion criteria and were admitted between September 2021 and September 2023. The 40 patients were divided into two groups： the collagenase group（ 22 patients） received treatment with TTT combined with collagenase ointment， while the non-collagenase group （18 patients） received TTT treatment alone. The clinical efficacy， follow-up results and auxiliary examination findings were compared between the two groups. Results The hospitalization time， antibiotic usage time， wound dressing frequency， and the reduction rate of wound area upon discharge in the collagenase group were all better than those in the non-collagenase group（ P<0.05）. During the follow-up period， the wound healing time in the collagenase group was shorter than that in the non-collagenase group （P<0.05）. One week after surgery and one month after surgery， the WBC， CRP， and ESR in the collagenase group were all better than those in the noncollagenase group（ P<0.05）. Conclusion The combination of TTT technology and collagenase for the treatment of refractory diabetic foot ulcers can improve distal limb blood supply while ensuring thorough debridement， thereby shortening treatment duration and reducing recurrence rates.

Key words: Diabetic foot, &emsp, Tibial transverse transport, &emsp, Collagenase, &emsp, Revascularization