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Our earlier work introduced a wound surgical integrated treatment (WSIT) for DFUs, yielding promising outcomes. This study focuses on a specific WSIT protocol employing antibiotic\u2010loaded bone cement (ALBC) in the first Stage, and free vastus lateralis muscle\u2010sparing (VLMS) flaps and split\u2010thickness skin grafts (STSGs) in the second stage to repair non\u2010weight\u2010bearing DFUs. From July 2021 to July 2023, seven DFU patients (aged 47\u201371\u2009years) underwent this treatment. Demographic data, hospital stay and repair surgery times were collected. Histological and immunohistochemical analyses assessed angiogenesis, collagen deposition and inflammation. SF\u201036 questionnaire measured pre\u2010 and postoperative quality of life. Preoperative ultrasound Doppler showed that the peak blood flow velocity of the recipient area artery was significantly &gt;30\u2009cm\/s (38.6\u2009\u00b1\u20096.8\u2009cm\/s) in all patients. Muscle flap sizes varied from 8\u2009\u00d7\u20093.5\u2009\u00d7\u20091 to 18\u2009\u00d7\u20096\u2009\u00d7\u20092\u2009cm. The operation time of the repair surgery was 156.9\u2009\u00b1\u200915.08\u2009minutes, and the hospital stay was 18.9\u2009\u00b1\u20093.3\u2009days. Histological analysis proved that covering DFUs with ALBC induced membrane formation and increased collagen, neovascularization and M2 macrophages fraction while reducing M1 macrophages one. All grafts survived without amputation during a 7\u2010 to 24\u2010month follow\u2010up, during which SF\u201036 scores significantly improved. A combination of ALBC with free VLMS flaps and STSGs proved to be safe and effective for reconstructing non\u2010weight\u2010bearing DFUs. It rapidly controlled infection, enhanced life quality and foot function, and reduced hospitalization time. We advocate integrating this strategy into DFU treatment plans.<\/jats:p>","DOI":"10.1111\/iwj.14900","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T01:35:40Z","timestamp":1714959340000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Combining antibiotic\u2010loaded bone cement\u2010based free vastus lateralis muscle\u2010sparing flap with split\u2010thickness skin grafts: A reliable strategy for reconstructing diabetic foot ulcers at non\u2010weight\u2010bearing areas"],"prefix":"10.1111","volume":"21","author":[{"given":"Shusen","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Burns and Plastic Surgery Affiliated Hospital of Zunyi Medical University  Zunyi PR China"},{"name":"The Collaborative Innovation Center, Tissue Damage Repair and Regeneration Medicine of Zunyi Medical University  Zunyi PR 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