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

Authors

  • Mehwish Mooghal Department of Surgery, Bahria University Medical and Dental College, Karachi, Pakistan http://orcid.org/0000-0002-6386-4047
  • Muhammad Usman Department of Surgery, Bahria University Medical and Dental College, Karachi, Pakistan
  • Wajiha Khan Dow University of Health Sciences, Karachi, Pakistan
  • Lal Bux Brohi Department of Surgery, Bahria University Medical and Dental College, Karachi, Pakistan
  • Asrar Ahmad Department of Surgery, Bahria University Medical and Dental College, Karachi, Pakistan
  • Kamran Rahim Department of Surgery, Bahria University Medical and Dental College, Karachi, Pakistan

DOI:

https://doi.org/10.18203/2349-3259.ijct20214106

Keywords:

DFU, VAC, Healing time

Abstract

Background: Diabetic foot ulcers (DFU’s) are chronic wounds in diabetics resulting from ischemia, angiogenesis defects and impaired immunity. Vacuum assisted closure (VAC) provides a new paradigm for diabetic wound dressing. This study compares the mean healing time of wound after VAC versus conventional dressing (CD) in DFU patients.

Methods: This randomized controlled trial carried out at surgery department, at tertiary teaching hospital over a period from 28th February-27th August 2020. Total 60 patients of age (25-75 years), both genders having DFU were included. Patients were placed randomly into two groups i.e., group A (VAC therapy) and group B (CD), by using lottery method. Mean healing time noted in both groups. For statistical analysis, SPSS version 20.0 was used. Independent ‘t’ test used to compare the mean healing time of both groups and p≤0.05 considered significant. Effect modifiers were controlled through stratification and post-stratification independent ‘t’ test, to see their effect on healing time. P≤0.05 was considered significant.

Results: The mean age of patients in group A was 53.13±9.09 years and in group B was 53.53±9.09 years. Out of 60 patients 41 (68.33%) were males and 19 (31.67%) were females. The mean healing time of wound in DFU patients after VAC closure (group A) was 12.07±2.15 days and after CD (group B) was 17.50±3.16 days with p=0.0001.

Conclusions: Study concluded that mean healing time after VAC is less in DFU patients as compared to CD.

Author Biographies

Mehwish Mooghal, Department of Surgery, Bahria University Medical and Dental College, Karachi, Pakistan

Resident at department of surgery , PNS Shifa Hospital Karachi, affiliated with Bahria University Medical and Dental College ,Karachi, Pakistan.

Muhammad Usman, Department of Surgery, Bahria University Medical and Dental College, Karachi, Pakistan

FCPS (Registrar Surgery PNS Shifa hospital Karachi)

Wajiha Khan, Dow University of Health Sciences, Karachi, Pakistan

Medical Student

Lal Bux Brohi, Department of Surgery, Bahria University Medical and Dental College, Karachi, Pakistan

Senior Registrar

Asrar Ahmad, Department of Surgery, Bahria University Medical and Dental College, Karachi, Pakistan

Assistant Professor Surgery

Kamran Rahim, Department of Surgery, Bahria University Medical and Dental College, Karachi, Pakistan

Assistant Professor Surgery

References

Lone AM, Zaroo MI, Laway BA, Pala NA, Bashir SA, Rasool A. Vacuum-assisted closure versus conventional dressings in the management of diabetic foot ulcers: a prospective case-control study. Diabet Foot Ankle. 2014;5:1.

Ravari H, Modaghegh MHS, Kazemzadeh GH, Johari HG, Vatanchi AM, Sangaki A et al. Comparision of vacuum-asisted closure and moist wound dressing in the treatment of diabetic foot ulcers. J Cutan Aesthet Surg. 2013;6:17-20.

Novak A, Khan W, Palmer J. The evidence-based principles of negative pressure wound therapy in trauma and orthopedics. Open Orthopaed J. 2014;8(1):168-77.

Patmo A, Krijnen P, Tuinebreijer W, Breederveld R. The effect of vacuum-assisted closure on the bacterial load and type of bacteria: a systematic review. Adv Wound Care. 2014;3(5):383-9.

Lavery LA, Murdoch DP, Kim PJ, Fontaine JL, Thakral G, Davis KE. Negative Pressure Wound Therapy With Low Pressure and Gauze Dressings to Treat Diabetic Foot Wounds. J Diabetes Sci Technol. 2014;8(2):346-9.

Aslam R, Rehman B, Nasir IU, Ahmed R, Iftikhar M, Sayyar M. Comparison of vacuum assisted closure versus conventional dressings in treatment of diabetic foot ulcers. Khayber J Med Sci. 2015;8(2):226-30.

Webb LX. New techniques in wound management: vacuum-assisted wound closure. J Am Acad Orthop Surg. 2002;10(5):303-11.

Andrabi SH, Ahmad J, Rathore MA, Yousaf M. Vacuum assisted closure of laparostomy wounds “a novel technique”. J Ayub Med Coll. 2007;19(3):89-92.

Lambert K, Hayes P, McCarthy P. Vacuum assisted closure: a review of development and current applications. Eur J Vasc Endovas Surg. 2003;29(3):219-26.

Babul A. Wound healing. In: Brunicardi FC, Anderson DK, Dunn DL, Hunter JG, Pollock RE. Schwartz’s principles of surgery. New York: Mc-Graw Hill Companies, Inc. 2005;223-48.

Ballard K, McGregor F. Use of vacuum-assisted closure therapy following foot amputation. Bri J Nursing Aug. 2001;10(15):S6-12.

Banwell PE, Musgrave M. Topical negative pressure therapy: mechanisms and indications. Int Wound J. 2004;1(2):95-106.

Herscovici DJ, Sanders RW, Scaduto JM, Infante A. Vacuum-assisted wound closure (VAC Therapy) for the management of patients with high-energy soft tissue injuries. J Orthop Trauma. 2003;17(10):683.

McCallon SK, Knight CA, Valiulus JP, Cunningham MW. Vacuum assisted closure versus saline moisture gauze in the healing of postoperative diabetic foots. Ostomy Wound Manang. 2000;46(8):28-32.

Singh B, Sharma S, Jaswal KS. Comparison of negative pressure wound therapy v/s conventional dressings in the management of chronic diabetic foot ulcers in a tertiary care hospital in North India. Int J Sci Res. 2017;6(8):948-53.

Mouës CM, Vos MC, Van den Bemd GJ, Stijnen T, Hovius SE. Bacterial load in relation to vacuum-assisted closure wound therapy: a prospective randomized trial. Wound Repair Regen. 2004;12(1):11.

Zhang J, Hu ZC, Chen D, Guo D, Zhu JY, Tang B. Effectiveness and safety of negative-pressure wound therapy for diabetic foot ulcers: a meta-analysis. Plastic and Reconstructive Surg. 2014;134(1):141-51.

Eginton MT, Brown KR, Seabrook GR, Towne JB, Cambria RA. A prospective randomised evaluation of negative-pressure wound dressings for diabetic foot wounds. Ann Vasc Surg. 2003;17:645-9.

Blume PA, Walters J, Payne W, Ayala J, Lantis J. Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers: a multicenter randomized controlled trial. Diabetes Care. 2008;31(4):631-6.

Riaz MU, Rauf M U, Akbar KA. Comparison of vacuum assisted closure v/s normal saline dressing in healing diabetic wounds. Pak J Med Health Sci. 2010;4(4):308-12.

El-Marakbi A, Gamal A, Darwish H, Saad A. Efficacy of vacuum assisted closure (vac) therapy in healing of diabetic foot ulcer and after diabetic foot amputation. Kasr El Aini J Surg. 2010;11:57-66.

Vikatmaa P, Juutilainen V, Ukasjarvi P, Malmivaara A. Negative pressure wound therapy: a systematic review on effectiveness and safety. Eur J Vasc Endovasc Surg. 2008;36:438-48.

Dsouza C, Rouchelle, Chirag, Diaz E, Rao S. A randomized controlled trial comparing low-cost vacuum assisted dressings and conventional dressing methods in the management of diabetic foot ulcers. Int Surg J. 2017;4:3858-65.

James SMD, Sureshkumar S, Elamurugan TP, Debasis N, Vijayakumar C, Palanivel C. Comparison of Vacuum-Assisted Closure Therapy and Conventional Dressing on Wound Healing in Patients with Diabetic Foot Ulcer: A Randomized Controlled Trial. Niger J Surg. 2019;25(1):14-20.

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Published

2021-10-22

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Original Research Articles