Department of Surgery, Maulana Azad Medical College, New Delhi, India.
Diabetes Metab Syndr. 2021 Jan-Feb;15(1):365-371. doi: 10.1016/j.dsx.2021.01.014. Epub 2021 Jan 23.
Foot ulcers are one of the major causes of morbidity and mortality among diabetics in India. Early diagnosis and timely management is vital in preventing the progression of the disease which may require amputation. Conventional methods take a long time for healing. This study aims to compare negative pressure wound therapy (NPWT) and conventional saline dressings in diabetic foot ulcer (DFU) healing.
This prospective randomized study was conducted in 45 patients with grade 1 and 2 DFUs. 22 patients in group A received NPWT and 23 patients in group B received saline dressings. The formation of granulation tissue, reduction in ulcer size, duration of hospital stay and time for complete healing of wounds were assessed.
The formation of granulation tissue (91.14 vs 52.61%, p < 0.001) and reduction in ulcer size (40.78 vs 21.18%, p = 0.008) at 14 days was significantly more in group A. The duration of hospital stay (15.68 vs 29.00 days, p < 0.001) and time for 100% coverage of the wound with granulation tissue (14.82 ± 7.30 vs 44.57 ± 7.11 days, p < 0.001) was significantly less in group A. Complete healing of wounds at 3 months was observed in 20 patients (90.9%) in group A and 6 patients (26.1%) in group B (p = 0.006).
In our study NPWT led to early reduction in ulcer size, more granulation tissue formation, shorter hospital stay and complete wound healing. In lower and middle income countries like India with high prevalence of DFUs, early recovery is a boon to the patients to resume their daily activities.
足部溃疡是印度糖尿病患者发病率和死亡率的主要原因之一。早期诊断和及时治疗对于预防疾病进展至关重要,因为疾病进展可能需要截肢。传统方法需要很长时间才能愈合。本研究旨在比较负压伤口治疗(NPWT)和常规盐水敷料在糖尿病足溃疡(DFU)愈合中的效果。
这是一项前瞻性随机研究,纳入了 45 名 1 级和 2 级 DFU 患者。22 例患者在 A 组接受 NPWT,23 例患者在 B 组接受盐水敷料。评估肉芽组织形成、溃疡面积缩小、住院时间和伤口完全愈合时间。
第 14 天时,A 组肉芽组织形成(91.14%比 52.61%,p<0.001)和溃疡面积缩小(40.78%比 21.18%,p=0.008)更明显。A 组住院时间(15.68 天比 29.00 天,p<0.001)和肉芽组织完全覆盖伤口的时间(14.82±7.30 天比 44.57±7.11 天,p<0.001)明显更短。A 组 3 个月时观察到 20 例(90.9%)患者伤口完全愈合,B 组 6 例(26.1%)患者伤口完全愈合(p=0.006)。
在我们的研究中,NPWT 导致溃疡面积更早缩小,更多肉芽组织形成,住院时间更短,伤口完全愈合。在印度等中低收入国家,DFU 患病率高,早期康复对患者恢复日常活动是一种福音。