Introduction

Despite advances made in diagnosing and controlling diabetes mellitus (DM), treatment of diabetic foot ulcers (DFUs) is still among challenges faced by physicians. Negative pressure wound therapy (NPWT) is one of newer modalities proposed in the treatment of DFUs. However, there is lack of evidence to support its mileage in this regard. This study was conducted with the aim of assessing the efficacy of NPWT in healing process of DFUs.

Materials and methods

Sixty patients with DM were randomly allocated into two groups consisting of 30 patients each: the intervention group received sub-atmospheric pressure of − 75 to − 100 mmHg (5 min on, 2 min off) with dressings changed every 48 h, and the control group was treated with silver sulfadiazine dressings, changed twice daily. Patients were followed up until complete closure of ulcers, with a mean duration of 3 months.

Results

Of the total 60 patients, 27 patients (45%) were females. Most of the patients in both groups had DFUs of grade 2 according to Wegner’s classification. Rate of healing of the ulcers was significantly higher by using NPWT (p-value 0.01). NPWT also caused a significant reduction in ulcer surface area, depth, size, major and minor amputations, and disability duration (p-values 0.008, 0.002, 0.02, 0.03, and 0.01, respectively). No significant decrease in occurrence of complications was seen with NPWT.

Conclusion

NPWT seems to be more efficacious than conventional dressing in treating infected DFUs.

中文翻译：

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负压伤口疗法与传统敷料相比在治疗糖尿病足溃疡中的功效：一项随机对照试验

介绍

尽管在诊断和控制糖尿病（DM）方面取得了进展，但是糖尿病足溃疡（DFU）的治疗仍然是医师面临的挑战。负压伤口治疗（NPWT）是治疗DFU的较新方法之一。但是，在这方面缺乏证据支持其发展。进行这项研究的目的是评估NPWT在DFU愈合过程中的功效。

材料和方法

60例DM患者被随机分为两组，每组30例：干预组接受的气压为-75至-100 mmHg（5分钟开，2分钟关），每48小时换药一次，对照组为对照组。本组用磺胺嘧啶银敷料治疗，每天更换两次。对患者进行随访直至溃疡完全闭合，平均持续时间为3个月。

结果

在总共60例患者中，有27例（45％）是女性。根据Wegner的分类，两组中大多数患者的DFU均为2级。通过使用NPWT，溃疡的治愈率明显更高（p值0.01）。NPWT还引起溃疡表面积，深度，大小，主要和次要截肢以及残疾持续时间的显着减少（p值分别为0.008、0.002、0.02、0.03和0.01）。NPWT未见并发症发生率显着降低。

结论

NPWT在治疗感染的DFU方面似乎比常规敷料更有效。