Is vacuum assisted closure dressing better than conventional management of diabetic wounds?

Authors

  • Abhijit Bagul Department of Surgery, D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India
  • Nandkishor Narwade Department of Surgery, D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India
  • Ankit Bhupatkar Department of Surgery, D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India
  • Sridevi Murali Department of Surgery, D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India
  • Yashraj Shah Department of Surgery, D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20182222

Keywords:

Diabetic wounds, VAC dressing

Abstract

Background: Foot ulcers are a major cause of hospitalization in patients with Diabetes Mellitus (DM) which increases hospital stay because of multiple surgical procedures, prolonged length of stay. The objectives of this study were to test the conventional therapy for diabetic wounds with respect to time and wound healing, to compare the outcomes of the two methods after a stipulated period and to prove the efficacy of one method over the other by appropriate statistical methods at the end of data collection.

Methods: A prospective randomized hospital based observational study of 47 patients was conducted at the Hospital of D. Y. Patil University School of Medicine, Nerul, Navi Mumbai, Maharashtra, India for a period of 24 months (June 2014 to June 2016). All these 47 patients were studied, and the data was statistically evaluated to determine the efficacy of vacuum assisted closure in healing of diabetic wounds and to compare it with conventional method of treatment of diabetic wounds. The patients were divided into 2 groups, Group ‘A’ which consisted of 22 who received Vacuum Therapy (VAC), Group ‘B’ which consisted of 25 and received conventional dressing.

Results: The patients on VAC therapy had early appearance of granulation tissue as compared to patients treated by Conventional dressing (90.9% Vs 76% at the end of one week. All patients developed granulation tissue by the end of 2 weeks.

Conclusions: We thus conclude that VAC appears to be superior compared to conventional dressings in the treatment of diabetic foot ulcers in terms of early appearance of granulation tissue and decrease in wound depth.

Metrics

Metrics Loading ...

References

Ahmed AM. History of diabetes mellitus. Saudi Med J. 2002;23:373-8.

Nalini S, David G, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA. 2005;293:217-28.

Reiber GE, Vileikyte L, Boyko EJ, Del AM, Smith DG, Lavery LA, et al. Causal pathways for incident lower extremity ulcers in patients with diabetes from two settings. Diabetes Care. 1999;22:157-62.

White R, McIntosh C. Topical therapies for diabetic foot ulcers: standard treatments. J Wound Care. 2008;17:426-32.

Joseph E, Hamori CA, Bergman S, Roaf E, Swann NF, Anastasi GW. Prospective randomized trial of vacuum assisted closure versus standard therapy of chronic non-healing wounds. Wounds. 2000;12:60-7.

Moisidis E, Heath T, Boorer C, Ho K, Deva AK. Prospective, blinded, randomized, controlled clinical trial of topical negative pressure use in skin grafting. Plast Reconstr Surg. 2004;114:917-22.

Oyibo SO, Jude EB, Tarawneh I, Nguyen HC, Harkless LB, Boulton AJ. A comparison of two diabetic foot ulcer classification systems the Wagner and the University of Texas wound classification systems. Diabetes care. 2001;24.1:84-8.

Moss SE, Klein R, Klein BE. Prevalence and incidence of lower extremity amputation in diabetic foot. Arch Int Med. 1992;152:610-6.

Wattle F, Mathieu D, Coqet JM, Billard V. Hyperbaric oxygen therapy in chronic vascular wound management. Angiol. 1990;41:51-65.

Lone AM, Zaroo MI, Laway BA, Pala NA, Bashir SA, Rasool A. Vacuum assisted closure versus conventional dressings in the management of diabetic foot ulcers: a prospective case-control study. Diabet Foot Ankle. 2014;5(1):23345.

Reiber GE. Epidemiology and health care costs of diabetic foot problems. The diabetic foot. Humana Press. 2002; 35-58.

Sowers JR, Levy J, Zemel MB. Hypertension and diabetes. The Medical Clinics of North America. 1988;72.6:1399-414.

Armstrong DG, Lavery LA. Diabetic Foot Study Consortium. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre randomized controlled trial. Lancet. 2005;366:1704-10.

Eginton MT, Brown KR, Seabrook GR, Towne JB, Cambria RA. A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds. Ann Vasc Surg. 2003;17(6):645-9.

Braakenburg A, Obdeijn MC, Feitz R, van Rooij IA, van Griethuysen AJ, Klinkenbijl JH. The clinical efficacy and cost effectiveness of the vacuum assisted closure technique in the management of acute and chronic wounds: a randomized controlled trial. Plast Reconstr Surg. 2006;118(2):390-7.

Downloads

Published

2018-05-24

Issue

Section

Original Research Articles