To discuss the application value of debridement combined with antibiotic bone cement in the treatment of severe infection of diabetic foot ulcer (DFU).

Nineteen patients with severe infection of DFU (Wagner grade 3 or above, severe infection) hospitalized in the Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University from June 2019 to June 2020 were retrospectively analyzed. Their wounds were expanded and filled with antibiotic bone cement. After infection control, direct sutures, skin grafting or flap transplantation were performed. White blood cell count, C-reactive protein, absolute value of neutrophil and procalcitonin were collected before and 7 days after debridement combined with antibiotic bone cement treatment, and the time, frequency of bone cement coverageand were recorded and the efficacy of treatment was evaluated. Data were compared with t test and variance analysis.

The infection of 19 patients was controlled effectively. After 7 days of treatment, the white blood cell count, C-reactive protein, absolute value of neutrophil and procalcitonin were (6.39±1.55)×10⁹/L, (25.47±14.65) mg/L, 5.55±1.64, which were significantly lower than before treatmen [(12.97±5.27)×10⁹/L, (126.13±42.64) mg/L, (9.68±4.04)], the differences were statistically significant (t=2.995, 3.842, 4.743; P<0.05); the level of procalcitonin decrease compared with before treatment, but the difference was not statistically significant (P>0.05). The covering time of bone cement were 10-61 days, and the covering frequency of bone cement was 1.4 times per person. Among the 19 cases, 12 cases were cured by direct suture, skin graft or skin flap transplantation after antibiotic bone cement filling, 2 cases were changed dressing until cured after bone cement treatment, amputation in 2 cases and loss of follow-up in 3 cases. The patient was not hospitalized again during the follow-up period.

Antibiotic bone cement is an effective method in the treatment of DFU with severe infection, which could provide wound bed preparation for the following wound repair.