Effectiveness and safety of negative-pressure wound therapy for diabetic foot ulcers: a meta-analysis.

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Author Information

  1. Department of General Surgery, B. J. Medical College, Ahmedabad, Civil Hospital, Asarwa, Ahmedabad India.
  2. Department of General Surgery, Government Medical College, Vadodara, India.


Diabetic foot wounds present a great challenge to surgeons. They are difficult to heal and are a significant risk factor for non-traumatic foot amputation besides being a huge financial burden. NPWT systems commercially available (VAC™ system, KCI Inc., USA) are costly precluding widespread use.

To determine whether negative-pressure wound therapy (NPWT) would afford quicker wound recovery as compared to saline-moistened gauze in the treatment of diabetic foot wounds. Sixty patients were randomized into either the experimental NPWT group or conventional dressing group (control). All patients were given medical therapy for diabetes and antibiotics given according to culture and sensitivity patterns.

All foot ulcers were surgically debrided prior to initiation of NPWT or conventional treatment. In the NPWT group, dressings were changed every 48-72 h. In the control group, conventional dressings were applied at the time of surgical debridement and changed twice a day thereafter.

End point of study was when wound was ready for either skin grafting or secondary suturing. End point was achieved in the NPWT group in 17.2(SD ± 3.55) days, compared to 34.9 (SD ± 5.96) days in the control group (p < 0.001). Number of dressing applied were 7.46(SD ± 2.25) in NPWT group versus 69.8(SD ± 11.93) in conventional dressing group (p < 0.001).

Ninety percent cases were successfully treated in NPWT Group as compared to 76.6 % in conventional group. Rate of healing of ulcer is faster in NPWT group as compared to conventional group. Economically modified NPWT is more cost-effective to the patients in our setup.

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