A randomized controlled trial comparing low cost vacuum assisted dressings and conventional dressing methods in the management of diabetic foot ulcers
Journal Title: Medpulse International Journal of Surgery - Year 2017, Vol 4, Issue 3
Abstract
Background: Diabetic neuropathy directly contributes in genesis of non healing diabetic ulcers, ischemic necrosis leads to tissue breakdown. VAC therapy influences positive mechanical forces on the growth of tissues, especially in stimulating cell migration and mitosis. It optimizes blood flow, decreases local tissue edema from the wound bed. It also enhances bacterial clearance . VAC therapy provides an occlusive environment for wound healing under moist, clean and sterile conditions. This promotes healthy granulation in the wound. Such a sterile, occlusive environment is not given by conventional dressings. Aims and Objectives: To compare the effectiveness of low cost hospital made vacuum assisted closure with conventional dressings in healing of diabetic foot ulcers, in terms of granulation tissue formation along with change in wound dimensions, bacterial clearance and patient satisfaction. Materials and Methods: This study was a prospective, randomized controlled trial and included 60 patients with diabetic foot ulcers admitted in the Surgery and Orthopaedics departments of Father Muller Medical College Hospital. The study was conducted over a duration of 3 months in 2015 and was approved by the Ethical Committee. 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. Statistics: 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. In the ulcers which underwent conventional dressing at the end of therapy, 46.7% had red granulation tissue. 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. In the conventional dressing group, on day one 79.17% were rendered sterile at the end of therapy.
Authors and Affiliations
Caren D’souza, Rochelle Rochelle, Shubha Rao, Erel Diaz
Keywords
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