Vacuum-assisted closure versus moist dressings in the treatment of diabetic wound ulcers after partial foot amputation: A retrospective analysis in 65 patients

• Published in: Journal of orthopaedic surgery (Hong Kong) Vol. 26; no. 3; p. 2309499018799769
• Main Authors: Sukur, Erhan, Akar, Abdulhalim, Uyar, Ahmet Çagrı, Cicekli, Ozgur, Kochai, Alauddin, Turker, Mehmet, Topcu, Huseyin Nevzat
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-09-2018; Sage Publications Ltd; SAGE Publishing
• Subjects: Amputation; Authorship; Biomechanics; Diabetes; Foot diseases; Leg ulcers; Medical dressings; Patients; Performance evaluation; Standard deviation; Surgery; Ulcers; United States > US; VAC; partial foot amputation; reamputation; diabetic food ulcer
• ISSN: 2309-4990; 1022-5536; 2309-4990
• DOI: 10.1177/2309499018799769

Purpose:
Changes in weight-bearing patterns after partial foot amputations may lead to new localized high-pressure points and keratosis due to ulcerations in patients with neuropathies and hypovascular limbs. As a result, diabetic foot ulcers (DFUs) after partial foot amputations are very complex. The aim of this study was to compare the effectiveness of vacuum-assisted closure (VAC) therapy with conventional moist wound dressings in the treatment of diabetic wound ulcers after partial foot amputations.
Methods:
Sixty-five diabetic patients with a DFU, who had previously undergone partial foot amputation surgery, were assigned to treatment with VAC (group A: 31 patients) or conventional wound moist dressing (group B: 34 patients). The final results were considered as failed treatment if reamputation was required. Conversely, reaching 90% of wound granulation was considered to be a successful endpoint.
Results:
The average time to reach 90% granulation tissue was significantly lower in group A (7.8 ± 1.2 weeks vs. 11.1 ± 1.2 weeks; p < 0.001). However, there was no significant difference regarding the reamputation requirements; 38.7% (12 patients) in group A and 41.2% (14 patients) in group B, (p = 0.839).
Conclusion:
The results of this study allowed us to conclude that VAC therapy system appears to be an effective treatment for patients with complex DFUs who had previously undergone partial foot amputation.