A PROSPECTIVE CASE-CONTROL STUDY- VACUUM-ASSISTED CLOSURE VERSUS SURGICAL DEBRIDEMENT IN THE MANAGEMENT OF DIABETIC FOOT ULCERS.

Dr. Rajashekara Babu G.; Dr. Nikhil S.; Dr. Chandrashekar M.S.

Volume : VII, Issue : IX, September - 2018

A PROSPECTIVE CASE-CONTROL STUDY- VACUUM-ASSISTED CLOSURE VERSUS SURGICAL DEBRIDEMENT IN THE MANAGEMENT OF DIABETIC FOOT ULCERS.

Dr. Rajashekara Babu G. , Dr. Nikhil S. , Dr. Chandrashekar M. S.

Abstract :

India with 42 million diabetics. Foot ulceration is the most common complication affecting approximately 15% of diabetic patients during their lifetime. The objective of the study was to compare the effectiveness of vacuum–assisted closure (VAC) versus Surgical deidement in diabetic foot ulcerations (DFUs) in terms of healing rate (time to prepare the wound for closure either spontaneously or by surgery), safety, and patient satisfaction.

METHODS: The study enrolled 40 patients, divided into two groups. Group A (patients treated with VAC) and Group B (patients treated with conventional dressings), with an equal number of patients in each group. DFUs were treated until wound closure, spontaneously, surgically, or completion of the 8–weeks.

RESULTS: Granulation tissue appeared in 14 (70%) patients by the end of Week 2 in Group A, while it appeared in 6 (30%) patients by that time in Group B. 100% granulation was achieved in all the patients by the end of Week 5 in Group A as compared to only 10 (5%) patients by that time in Group B. Patients in Group A had fewer number of positive wound cultures, secondary amputations and had better treatment compliance as compared to Group B.

CONCLUSION: VAC therapy is useful in the treatment of diabetic foot infection s, which after deidement, may present with exposed tendon, fascia or bone. These included ray amputation wounds, wounds post–deidement for necrotising fasciitis, wounds post–drainage for abscess, a heel ulcer and a sole ulcer. VAC prepared ulcers well for closure in good time. It reduced cost of therapy by hastening the reduction of wound area. VAC therapy provided a sterile, controlled resting environment to large, exudating wounds. Large diabetic foot ulcers were thus made more manageable.