Therapeutics and Clinical Risk Management (Oct 2018)
Efficacy of negative pressure wound therapy using vacuum-assisted closure combined with photon therapy for management of diabetic foot ulcers
Abstract
Xiaoxiao Hu,1,* Weishuai Lian,1,* Xiaojun Zhang,2,* Xue Yang,3,* Jinxia Jiang,4 Maoquan Li1 1Department of Interventional Vascular Surgery, The Tenth People’s Hospital affiliated to Tongji University, Tongji University School of Medicine, Shanghai, 200072, China; 2Department of Interventional Catheter, The Tenth People’s Hospital affiliated to Tongji University, Shanghai, 200072, China; 3Department of Anesthesiology, Eastern Hospital Affiliated to Tongji University, Shanghai, 200120, China; 4Department of Emergency, The Tenth People’s Hospital affiliated to Tongji University, Shanghai, 200072, China *These authors contributed equally to this work Background: Diabetes mellitus, one of the most prevalent chronic metabolic diseases, causes many complications. Among the complications, one of the most common chronic complications is diabetic foot ulcers (DFUs).Objective: This study was conducted to investigate the efficacy of negative pressure wound therapy using vacuum-assisted closure (VAC) combined with photon therapy for the management of DFUs.Patients and methods: The study included a total of 69 patients with DFUs during the period from January 2014 to December 2015. All patients were diagnosed with DFUs with Wagner’s stage 2 or 3 and were divided into two groups – the VAC group in which patients received only VAC and the combined group in which patients received both VAC and photon therapy. Data on duration of the treatment, pre- and postoperative wound surface areas, dressing changing times, pain conditions assessed using visual analog scale scores, recurrence rate and amputation rate were collected.Results: Among all patients, 35 patients were divided into the VAC group and 34 patients into the combined group. Areas of foot ulcers for all patients ranged from 5 to 100 cm2. The treatment duration, dressing changing times and the peak value of visual analog scale scores were all significantly lower in the combined group compared with the VAC group (P<0.05). However, the reduced area for wound surface showed no significant difference between the two groups. Both recurrence and amputation rates showed no significant difference between the two groups of patients.Conclusion: Both VAC and VAC combined with photon therapy were effective and safe in the treatment of DFUs, while the combined therapy might have accelerated wound healing, but did not influence the long-term efficacy. Keywords: diabetic foot ulcer, vacuum-assisted closure, photon therapy
