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

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. Materials and Methods: Prospective Randomized Controlled Trial in kamineni institute of medical sciences, Narketpally . 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: 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 less than 0.05). Wound size was measured at initial presentation and then after treatment. After wound management, mean surface area of the diabetic wounds was 36.08 ? 2.56 cm2 in the NPWT group and 37.63 ? 2.86 cm2 in the Conventional treatment. This represents a statistically significant difference (P=0.05). At the end of our study the incidence of secondary higher amputation in NPWT group was 5/25 (20%), the Conventional treatment 6/25 (24%). There was no significant difference between both groups (P=0.13). There is a statistically significant difference between average graft take-up and it is higher in vacuum dressing. It was 80.78 ? 14.54 in NPWT and 59.58?19.25 in control group. (P-value = 0.035). Daily mean cost in conventional dressing group was 67.43 ? 5.3 EP compared to 95.7 ? 10.2 EP in VAC group. A difference which is statistically different. Also, at the end of the study, total mean cost in conventional dressing group was 1976 ? 123 EP compared to 2275 ? 154 EP in VAC group. There was a difference in the total cost finally. Period of hospital stay till the wound was fully granulated and ready for skin grafting was 22.87 ? 7.62 in NPWT compared to 32.53 ? 10.17 in the conventional group. There is a highly statistically significant difference between average duration of hospital stay and it is reduced significantly in vacuum dressing. (p-value= 0.02). Conclusion: The rate of granulation tissue formation, wound surface area, overall graft survival was better in NPWT group as compared to conventional dressing group. Overall hospital stay and amputation rate were less in the NPWT group. Thus, NPWT can be considered as a superior option in the management of diabetic foot wounds. Cost of VAC therapy was higher than conventional dressing.