A randomized controlled trial comparing low cost vacuum assisted dressings and conventional dressing methods in the management of diabetic foot ulcers

Abstract

INTRODUCTIONIndia, is ranked first in the list of the ten nations most affected with diabetes, foot ulceration is the most common complication, affecting approximately 15% of diabetic patients during their lifetime. This can be attributed to several social and cultural practices such as barefoot walking, inadequate facilities for diabetes care and education, and poor socioeconomic conditions. 1 Diabetic foot ulceration followed by amputation contributes dramatically not only to the morbidity among persons with diabetes but is also associated with severe clinical depression. 2 ABSTRACTBackground: Diabetic foot ulcers are chronic wounds which are difficult to heal, due to ischemia and intrinsic defects in angiogenesis and impaired immunity against infection. VAC therapy influences positive mechanical forces on the growth of tissues, especially in stimulating cell migration and mitosis, optimizes blood flow, decreases local tissue edema from the wound bed and provides an occlusive environment for wound healing under moist, clean and sterile conditions. Aims and objective was to compare the effectiveness of low cost hospital made VAC dressing with conventional dressings in healing of diabetic foot ulcers. Methods: This study was a prospective, randomized controlled trial and included 60 patients with diabetic foot ulcers admitted over 3 months. Patients were randomly allocated to two groups: odd numbered patients to VAC therapy and the even numbered patients to conventional dressings. Wound swab was taken before the start of the study. The data was analyzed and presented in percentages or proportions using Chi-square test and Student-t-test wherever applicable. Results: In this study it was found that in the VAC dressing group 76.7% of the ulcers had red granulation tissue at the end of therapy compared to 46.7% in conventional group. The mean wound bed preparation time was found to be 15.60 days in the conventional dressing group and 8.50 days in the VAC therapy group. In the VAC group 72.73% ulcers had no bacteria at the end of therapy. Conclusion: In this study, it was found that Vacuum Assisted Closure therapy was more effective than conventional dressings in the wound bed preparation of diabetic foot ulcers.

Comparison of the mean healing time of wound after vacuum assisted closure versus conventional dressing in diabetic foot ulcer patients

“…VAC therapy appears to be more efficacious than conventional dressings in the preparation of diabetic ulcers. 23,24 We observed that the patients on VAC therapy had the early appearance of granulation tissue as compared to the patients treated by moist saline gauze dressings. Complete (100%) granulation was achieved earlier and in a higher proportion of patients in group A as compared to group B.…”