Comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer: A randomized controlled trial

Background: Vacuum-assisted closure (VAC) therapy has been shown to be beneficial in a variety of wounds. However, evidence of its benefit in diabetic foot ulcers (DFUs), especially with respect to Indian population, is sparse. Methodology: This randomized controlled trial included DFUs of Wagner�...

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Main Authors: Sangma M D James, Sathasivam Sureshkumar, Thirthar P Elamurugan, Naik Debasis, Chellappa Vijayakumar, Chinnakali Palanivel
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:Nigerian Journal of Surgery
Subjects:
Online Access:http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2019;volume=25;issue=1;spage=14;epage=20;aulast=James
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spelling doaj-658435646c294bf4b8115c72c747c15f2020-11-24T22:15:44ZengWolters Kluwer Medknow PublicationsNigerian Journal of Surgery1117-68062019-01-01251142010.4103/njs.NJS_14_18Comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer: A randomized controlled trialSangma M D JamesSathasivam SureshkumarThirthar P ElamuruganNaik DebasisChellappa VijayakumarChinnakali PalanivelBackground: Vacuum-assisted closure (VAC) therapy has been shown to be beneficial in a variety of wounds. However, evidence of its benefit in diabetic foot ulcers (DFUs), especially with respect to Indian population, is sparse. Methodology: This randomized controlled trial included DFUs of Wagner's Grades 1 and 2. Patients were further stratified with respect to DFU size <10 cm and ≥10 cm. Patients with vascular disease, osteomyelitis, and bilateral DFUs were excluded from the study. The enrolled patients were randomized to receive VAC therapy or conventional dressing. The time to wound healing, granulation tissue formation, and complications such as pain, infection, and bleeding were compared between the two groups. Results: A total of sixty patients were randomized, of which 27 in each group were analyzed. The mean time to healing in days was significantly less in VAC group (22.52 vs. 3.85; P < 0.0001). Mean time to achieve 75%–100% granulation tissue cover was significantly less in VAC group (23.33 vs. 32.15; P < 0.0001). Rate of granulation tissue formation was also found to be significantly better in VAC group (2.91 cm2/day vs. 2.16 cm2/day; P = 0.0306). There was no difference between the two groups with respect to wound infection and bleeding which are commonly attributed to VAC therapy. VAC therapy group had significantly lesser pain at week 3 (Visual Analog Scale score 3 vs. 4; P = 0.004). Conclusion: VAC therapy significantly decreases the time to complete wound healing, hastens granulation tissue formation, and reduces the ulcer area compared to conventional dressing. The study did not find any significant increase in the bleeding and infection in the VAC therapy group.http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2019;volume=25;issue=1;spage=14;epage=20;aulast=JamesDiabetic foot ulcergranulationnegative pressure wound therapyvacuum-assisted closure therapywound healing
collection DOAJ
language English
format Article
sources DOAJ
author Sangma M D James
Sathasivam Sureshkumar
Thirthar P Elamurugan
Naik Debasis
Chellappa Vijayakumar
Chinnakali Palanivel
spellingShingle Sangma M D James
Sathasivam Sureshkumar
Thirthar P Elamurugan
Naik Debasis
Chellappa Vijayakumar
Chinnakali Palanivel
Comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer: A randomized controlled trial
Nigerian Journal of Surgery
Diabetic foot ulcer
granulation
negative pressure wound therapy
vacuum-assisted closure therapy
wound healing
author_facet Sangma M D James
Sathasivam Sureshkumar
Thirthar P Elamurugan
Naik Debasis
Chellappa Vijayakumar
Chinnakali Palanivel
author_sort Sangma M D James
title Comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer: A randomized controlled trial
title_short Comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer: A randomized controlled trial
title_full Comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer: A randomized controlled trial
title_fullStr Comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer: A randomized controlled trial
title_full_unstemmed Comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer: A randomized controlled trial
title_sort comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer: a randomized controlled trial
publisher Wolters Kluwer Medknow Publications
series Nigerian Journal of Surgery
issn 1117-6806
publishDate 2019-01-01
description Background: Vacuum-assisted closure (VAC) therapy has been shown to be beneficial in a variety of wounds. However, evidence of its benefit in diabetic foot ulcers (DFUs), especially with respect to Indian population, is sparse. Methodology: This randomized controlled trial included DFUs of Wagner's Grades 1 and 2. Patients were further stratified with respect to DFU size <10 cm and ≥10 cm. Patients with vascular disease, osteomyelitis, and bilateral DFUs were excluded from the study. The enrolled patients were randomized to receive VAC therapy or conventional dressing. The time to wound healing, granulation tissue formation, and complications such as pain, infection, and bleeding were compared between the two groups. Results: A total of sixty patients were randomized, of which 27 in each group were analyzed. The mean time to healing in days was significantly less in VAC group (22.52 vs. 3.85; P < 0.0001). Mean time to achieve 75%–100% granulation tissue cover was significantly less in VAC group (23.33 vs. 32.15; P < 0.0001). Rate of granulation tissue formation was also found to be significantly better in VAC group (2.91 cm2/day vs. 2.16 cm2/day; P = 0.0306). There was no difference between the two groups with respect to wound infection and bleeding which are commonly attributed to VAC therapy. VAC therapy group had significantly lesser pain at week 3 (Visual Analog Scale score 3 vs. 4; P = 0.004). Conclusion: VAC therapy significantly decreases the time to complete wound healing, hastens granulation tissue formation, and reduces the ulcer area compared to conventional dressing. The study did not find any significant increase in the bleeding and infection in the VAC therapy group.
topic Diabetic foot ulcer
granulation
negative pressure wound therapy
vacuum-assisted closure therapy
wound healing
url http://www.nigerianjsurg.com/article.asp?issn=1117-6806;year=2019;volume=25;issue=1;spage=14;epage=20;aulast=James
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