DIFFERENT APPROACHES IN THE MANAGEMENT OF DIABETIC FOOT ULCERS – EXPERIENCE AT A TERTIARY CARE HOSPITAL

Abstract

Aims and Objectives: To compare the outcomes of the usage of the negative pressure wound therapy (NPWT) using vacuum assisted wound closure/ Collagen granules/ Offloading techniques with the conventional moist gauze dressing in the treatment of diabetic foot ulcers (DFU). Methods: Prospective, interventional study. Study conducted at B.L.D.E (DU)’s Shri B.M.Patil Medical College Hospital and Research Center, Vijayapur over a period of 5 years. The demographic characteristics, type of foot lesions and treatment with different modalities of dressings and outcome were studied. 50 cases in each group – NPWT/Collagen granules dressing/ offloading techniques and conventional moist gauze dressings were allocated alternatively. Results: 200 patients were included in the study, saw the gradual increase in the granulation tissue development, but the results were better in other groups than the conventional group and the collagen dressing group had more granulation tissue from week 1. There was early recovery among the other groups when compared to the conventional methods. The mean recovery were least in the collagen dressing group. 90% had good outcome in the negative dressing group. The outcome was 92% among the off loading group and 96% good outcome among the collagen group. But the conventional group had only 64% good outcome. And the difference was statistically significant. Conclusion: The comparison of different methods to treat the diabetic foot ulcer showed that collagen method of dressing to be superior to others followed by offloading and then by topical negative pressure dressing. The conventional method had less favorable and slow outcome.