Effect of Silver Nanoparticles With Thermoplastic Polyurethane on Postoperative Rehabilitation of Diabetic Patients With Open Fracture of Lower Extremities

Dong Zhang; Dongchen Yao; Ruofei Ma; Shaokui Nan; You Lv; Yue Zhu; Shiwen Zhu

doi:10.3389/fsurg.2022.954155

Effect of Silver Nanoparticles With Thermoplastic Polyurethane on Postoperative Rehabilitation of Diabetic Patients With Open Fracture of Lower Extremities

Front Surg. 2022 Jul 11:9:954155. doi: 10.3389/fsurg.2022.954155. eCollection 2022.

Authors

Dong Zhang¹, Dongchen Yao², Ruofei Ma², Shaokui Nan¹, You Lv¹, Yue Zhu¹, Shiwen Zhu²

Affiliations

¹ Department of Orthopedic Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China.
² Department of Traumatology and Orthopaedics, Beijing Jishuitan Hospital (The Fourth Medical College of Peking University), Beijing, China.

Abstract

Objective: This retrospective study aims to explore the effect of silver nanoparticles with thermoplastic polyurethane (TPU/NS) on the rehabilitation of diabetic patients with open fracture of lower extremities.

Methods: Diabetic patients (n = 98) with open fracture of lower extremities treated in our hospital were analyzed retrospectively from June 2015 to December 2021. TPU/NS nanocomposites were prepared for postoperative treatment of diabetic patients with open fracture of lower extremities. First, the cultured Staphylococcus aureus and Escherichia coli were used to test the antibacterial effect of TPU/NS dressing in vitro. After using TPU/NS dressing (observation group) and traditional dressing (control group), the inflammatory reaction, clinical treatment, functional rehabilitation, and adverse reactions in patients were compared.

Results: TPU/NS dressing effectively inhibited the growth of bacteria with a minimum inhibitory concentration of 2 μg/mL. The usage of TPU/NS dressing reduced the inflammatory reaction by reducing positive rate of bacteria after the dressing on the seventh day postoperatively. Besides, the times of dressing, stopping time of wound exudation, wound healing time, length of hospital stay, and VAS score in the observation group were lower than those in the control group; the incidence of adverse reactions after treatment was lower in the observation group as compared with the control group (17.07% vs. 35.09%). Meanwhile, the functional rehabilitation and life quality of patients in the observation group were better TPU/NS dressing treatment.

Conclusion: TPU/NS dressing has the function of promoting the postoperative recovery of patients by inhibiting the bacterial infection of the wound, thus improving the limb function and life quality. As a result, there was a tremendous potential to apply the constructed TPU/NS membrane to diabetic patients with open fractures, especially those with soft tissue injury.

Keywords: diabetes mellitus; nano-silver; open fracture; postoperative recovery; rapid rehabilitation.