{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T07:14:20Z","timestamp":1779261260984,"version":"3.51.4"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016692","name":"Key Research and Development Program of Ningxia","doi-asserted-by":"publisher","award":["2026BEH03006"],"award-info":[{"award-number":["2026BEH03006"]}],"id":[{"id":"10.13039\/100016692","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004772","name":"Natural Science Foundation of Ningxia Province","doi-asserted-by":"publisher","award":["2023AAC03493"],"award-info":[{"award-number":["2023AAC03493"]}],"id":[{"id":"10.13039\/501100004772","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004772","name":"Natural Science Foundation of Ningxia Province","doi-asserted-by":"publisher","award":["2024AAC03503"],"award-info":[{"award-number":["2024AAC03503"]}],"id":[{"id":"10.13039\/501100004772","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This retrospective cohort study aimed to compare the clinical efficacy and safety of a staged antibiotic-loaded bone cement combined with negative pressure wound therapy (AB-NPWT) pathway vs. flap transplantation in the treatment of chronic foot ulcers with soft tissue defects in patients with type 2 diabetes mellitus (T2DM) and osteoporosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 56 patients with T2DM and osteoporosis who underwent surgical treatment between January 2020 and December 2024. Treatment allocation was non-randomized and determined by the attending surgeon; no formal sample size calculation was performed. In the AB-NPWT group, 5 patients (17.2%) crossed over to receive local flap coverage as part of the staged pathway. The analysis was not adjusted for multiple comparisons. The AB-NPWT group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929) and flap transplantation group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927) were compared for perioperative parameters, wound healing, limb salvage, complications, and AOFAS scores. Adjusted analyses (multivariable regression and propensity score matching) were performed to account for potential confounding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Operative time and blood loss were significantly lower in the AB-NPWT group (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). At 12 months, complete wound healing (86.2% vs. 88.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.754), limb salvage (93.1% vs. 92.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.000), and median healing time (126 vs. 112 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.221) did not differ significantly between groups. Complication rates were similar (24.1% vs. 33.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.446), but profiles differed. AOFAS scores at final follow-up were comparable (72.5\u2009\u00b1\u200910.3 vs. 75.8\u2009\u00b1\u200911.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.270).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this retrospective exploratory cohort, no statistically significant between-group differences were detected in the main clinical outcomes. AB-NPWT was associated with reduced surgical trauma, whereas flap transplantation provided definitive coverage in a single operative session after debridement. Treatment selection should be individualized based on wound characteristics, patient systemic status, and healthcare resources. These findings are hypothesis-generating and require confirmation in larger prospective trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1834390","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T06:37:45Z","timestamp":1779259065000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Staged antibiotic-loaded cement-based reconstruction versus flap-based reconstruction for complex diabetic foot defects in patients with osteoporosis: a retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Hanlin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopedics Center, People\u2019s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]},{"name":"The Third Clinical Medical College, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Desheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Center, People\u2019s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]},{"name":"The Third Clinical Medical College, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Center, People\u2019s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]},{"name":"The Third Clinical Medical College, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fan","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Center, People\u2019s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]},{"name":"The Third Clinical Medical College, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peiling","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Center, People\u2019s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]},{"name":"The Third Clinical Medical College, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]},{"name":"General Practice Department, People\u2019s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Center, People\u2019s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]},{"name":"The Third Clinical Medical College, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Le","family":"Fei","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Center, People\u2019s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]},{"name":"The Third Clinical Medical College, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanchuan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Center, People\u2019s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University","place":["Yinchuan, Ningxia, China"]},{"name":"The Third Clinical Medical College, Ningxia Medical University","place":["Yinchuan, Ningxia, 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