Negative Pressure Wound Therapy Versus Conventional Dressing in Treatment of Diabetic Foot Wound

Abstract

Background: Foot wounds in people with diabetes mellitus are a common and serious global health issue. Negative pressure wound therapy can be used to treat these wounds and a clear and current overview of current evidence is required to facilitate decision-making regarding its use. Aim of the Work: To compare the efficacy of negative pressure wound therapy with that of a control group using conventional moist wound dressings, in healing of diabetic foot ulcers, in terms of 1) Change in size of wound. 2) Rate of granulation tissue formation as percentage of ulcer surface area. 3) Period of hospital stay. 4) Cost of both modalities of treatment. And 5) Complications after treatment. Study Design: Prospective Randomized Controlled Trial. Place: This study was conducted in the vascular surgery department at Al-Azhar university hospitals. Methodology: The study included 50 patients randomized into two groups (25 patient for VAC therapy & 25 patient for conventional dressing) suffering from diabetic foot wounds. Results: In our study, 6 of 25 (24%) in the Conventional treatment group were females whereas 19 of 25 (76%) in the Conventional treatment group were males. 3 of 25 (12%) in the NPWT group were females and 22 of 25 (88%) were males. In the Conventional treatment group, 21 of 25 (84%) were above 60 years of age. 20 of 25 (80%) in the NPWT group were above 60 years of age. Wound bed showed signs of healing by granulation tissue formation in 19 among 25 patients (76%) compared to Conventional treatment, 7 showed granulation among 25 patients (28%) one week after initiation of treatment. (P=0.001). Granulation of the wounds was > 50% in 20 of the 25 patients underwent NPWT whereas only 3 of the 25 in the Conventional treatment had shown > 50% granulation. There was a highly statistically significant difference between average Granulation as % of ulcer area and it is significantly high in vacuum dressing. It was 51.92 ± 21.03 in Conventional treatment compared with 78.68 ± 18.12 in NPWT group (p-value < 0.05). Wound size was measured at initial presentation and then after treatment.