The clinical efficacy comparison of tibial cortex transverse transport and platelet-rich plasma treatment of severe diabetic foot ulcers

Abstract

Abstract Objective The comparison analysis uses the clinical efficacy of the tibial cortex transverse transport and the enrichment of platelet plasma to treat severe diabetic foot ulcers and the effects of vascular endothelial cell vitality.Methods Retrospective analysis was performed on two groups of patients treated at our hospital from July 2019 to June 2022. One group received tibial cortex transverse transport (TTT) and the other received platelet-rich plasma (PRP). Both groups had Wagner level 3 or greater. We compared clinical efficacy, wound healing, arterial and posterior tibial arterial blood flow rates, and horizontal SDF-1 levels in peripheral blood between the groups.Results TTT group had higher healing rates at 1.5-year follow-up than the PRP group (96.67% [29/30] versus 80% [24/30], p < 0.05). The healing time of the TTT group was shorter than the control group (3.02 ± 0.84 versus 6.04 ± 0.85 months, p = 0.000). The amputation rate (3.33% [1/30] versus 20% [6/30], p < 0.05) and recurrence rate (6.67% [2/30] versus 26.67% [8/30], p < 0.05) of the TTT group were lower than the control group. One month after surgery and last follow-up, the SDF-1 concentration in the perimeter of the TTT group was significantly higher than the PRP group (375.36 ± 13.52 versus 251.93 ± 9.82 pg/ml, p = 0.000; 256.62 ± 13.19 versus 239.95 ± 10.78 pg/ml, p = 0.000). The average blood flow speed in the arterial artery of the TTT group was faster than the PRP group (68.93 ± 2.69 versus 58.14 ± 2.48 cm/s, p = 0.000) 4 weeks postoperatively and (55.68 ± 3.43 versus 46.07 ± 3.02 cm/s, p = 0.000) last follow-up.Conclusion The findings showed that TTT had better efficacy than PRP in treating severe diabetic foot ulcers. It could effectively stimulate SDF-1 expression, promote vascular hyperplasia, and accelerate wound healing.