Objective: To observe the distribution of pathogenic bacteria of moderate to severe diabetic foot infection (DFI) and the clinical effect of vancomycin-loaded bone cement combined with vacuum sealing drainage (VSD) on the treatment of moderate to severe DFI. Methods: There were 71 patients with moderate to severe DFI admitted from March 2017 to March 2020 who were collected retrospectively in the study. According to the patient’s condition

34 cases were treated with VSD only after thorough debridement (traditional group)

and 37 cases were treated with vancomycin-loaded bone cement combined with VSD after thorough debridement (combined group). The distribution of pathogenic bacteria in patients were analyzed

and the wound healing rate

wound healing time

total hospitalization time and depression rating scale (PHQ-9) and anxiety screening scale (GAD-7) scores 3 months after first treatment were compared between the two groups. Results: The results showed that 29 cases of pathogenic bacteria were detected in the traditional group

of which 17 cases of gram-negative bacteria accounted for 58.62%

and 12 cases of gram-positive bacteria accounted for 41.38%; the combined group detected 32 cases of pathogenic bacteria

of which 19 cases of gram-negative bacteria accounted for 59.38%

and 13 cases of positive bacteria accounted for 40.62%. There was no significant difference in the distribution of pathogenic bacteria detected between the two groups

and most of them were gram-negative bacteria. After 3 months of treatment

the healing rate was 94.59% (35/37) in the combined group and 76.47% (26/34) in the traditional group. Compared with the traditional group

the wound healing time

the total length of hospitalization and PHQ-9 and GAD-7 scores 3 months after the first treatment of patients in the combined group were significantly reduced

with statistically significant differences (P<0.05). Conclusion: Patients with moderate to severe DFI are mainly infected by gram-negative bacteria. Vancomycin-loaded bone cement combined VSD has achieved good results in the treatment of moderate to severe DFI.