The final, formatted version of the article will be published soon.
ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 15 - 2024 |
doi: 10.3389/fendo.2024.1420232
The association of the perioperative neutrophil-to-lymphocyte ratio with wound healing in patients with Wagner grade 3 and 4 diabetic foot ulcers after tibial cortex transverse transport surgery: A prospective observational cohort study
Provisionally accepted- 1 Mianyang Central Hospital, Mianyang, China
- 2 University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
Background: Diabetic foot ulcers (DFUs) are severe complications of diabetes, involving multiple etiological factors including neuropathy, vascular insufficiency, and impaired wound healing. The global burden of DFUs is substantial, with significant morbidity and high management costs. Recent advancements have introduced the Tibial Cortex Transverse Transport (TTT) technique, which has shown promising results in the management of severe DFUs by promoting angiogenesis and immunomodulation. Methods: This prospective cohort study enrolled patients with Wagner grade 3 and 4 DFUs, treated using the TTT technique from May 2022 to September 2023 at MianYang Central Hospital. The study assessed the influence of TTT on the perioperative neutrophil-tolymphocyte ratio (NLR), an established biomarker of systemic inflammation, and its correlation with wound healing outcomes. Results: A total of 82 patients were enrolled, with 66 completing the study. The survival analysis revealed that patients with a lower preoperative NLR experienced significantly faster wound healing compared with a high NLR (log rank test P < 0.05; hazard ratio (HR)=0.46; 95% CI: 0.26-0.83). The optimal NLR cut-off values (4.25) were established for predicting wound healing times for DFUs. The median NLR was significantly different before TTT surgery, 3-days after TTT surgery and 1 month after TTT surgery (P<0.05). Conclusion: TTT technique significantly influences the perioperative NLR and is associated with improved wound healing in DFU patients. The perioperative NLR serves as an effective predictive biomarker for wound healing outcomes, highlighting the significance of interventions targeting NLR values in perioperative management strategies and postoperative monitoring protocols for the treatment of diabetic foot ulcers (DFUs) in clinical practice.
Keywords: diabetic foot ulcer, Wagner grade 3 and 4, tibial cortex transverse transport technique, neutrophil-to-lymphocyte ratio (NLR), Wound Healing
Received: 19 Apr 2024; Accepted: 29 Sep 2024.
Copyright: © 2024 Zhao, Guo, zang, Hu, Yu, Zhang, Xie, Li, Bai, Shi and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Fudie Guo, Mianyang Central Hospital, Mianyang, China
Yonghui zang, Mianyang Central Hospital, Mianyang, China
Rong Hu, Mianyang Central Hospital, Mianyang, China
Xianjun Yu, Mianyang Central Hospital, Mianyang, China
Hongmei Zhang, Mianyang Central Hospital, Mianyang, China
Tingting Xie, Mianyang Central Hospital, Mianyang, China
Xiaoya Li, Mianyang Central Hospital, Mianyang, China
Chunxia Bai, Mianyang Central Hospital, Mianyang, China
Haoran Shi, Mianyang Central Hospital, Mianyang, China
Dingwei Zhang, Mianyang Central Hospital, Mianyang, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.