Efficacy of negative pressure wound therapy for the treatment of diabetic foot ulcer/gangrene

Abstract

A retrospective study was conducted to investigate the clinical efficacy of negative pressure wound therapy (NPWT) for the treatment of diabetic foot ulcers and gangrene. Thirty-two patients with diabetic foot ulcers and/or gangrene treated with NPWT (NPWT group) were compared with 48 patients with diabetic foot ulcers and/or gangrene whose wounds were treated by conventional wound treatment that maintained a moist environment prior to the introduction of the V.A.C.® System (pre-NPWT group). Among the 32 patients in the NPWT group, 2 patients (6.3 %) withdrew because of pain, 1 (3.3 %) was transferred to another hospital and was lost to follow-up, 5 (16.7 %) underwent lower limb amputation because of uncontrollable infection, and 1 (3.3 %) did not achieve wound closure during the observation period. The wounds of the remaining 23 patients in the NPWT group closed in an average of 91.5 ± 44.7 days. Among the 48 patients in the pre-NPWT group, the wounds of 20 patients (41.7 %) closed in an average of 138.0 ± 81.8 days. The time to closure was significantly shorter (log rank test, P = 0.02) despite the higher prevalence of log CRP and lower limb revascularization in the NPWT group. These findings suggest that NPWT may be more effective for healing diabetic foot ulcers and gangrene than conventional wound therapy.