Diabetic Foot Ulcer Clinical Trial
Official title:
Role of Negative Pressure Wound Therapy in the Management of Diabetic Foot Ulcers
Role of Negative Pressure Wound Therapy in the Management of Diabetic Foot Ulcers
• The aim of this study will be to assess negative pressure wound therapy in treating
diabetic foot ulcers.
Diabetic Foot ulcers are a major cause of admission in diabetic patients, and comprise a
disproportionately high number of hospital days because of multiple surgical procedures and
prolonged length of stay in Hospital.
The improvement in diabetes therapy and the reinforcement of guidelines have reduced the
amputation rate. The approach to diabetic foot ulcers has allowed the availability of several
medical options to ensure the best local condition and wound healing.
Negative-pressure wound therapy is a non-invasive therapy system that employs a controlled
negative pressure using a vacuum device to promote wound healing by removing fluid from open
wounds through a sealed dressing or a foam dressing connected to a container.
An earlier study has shown that NPWT reduced the need for subsequent amputations in a 6-month
follow-up period. This reflects the importance of this device in management of DFUs and
prevents its complications.
As most of the diabetic wounds present with infection, the success of NPWT is still highly
dependent upon the adequacy of surgical debridement and antimicrobial coverage.
NPWT provides a moist wound environment ideal for re-epithelialization, growth factor action,
angiogenesis, and granulation promotion.
Edema reduction produced by NPWT decreases interstitial pressure and positively promoting
wound vessel formation and improving wound circulation and lymphatic drainage, increasing the
availability of nutrients, oxygen and antibiotic therapy in the wound area. Some studies
showed that NPWT promotes an improvement of balance between proteases and their inhibitors
and influences cytokine modulation and promotes a positive wound environment.
Accurate classification of diabetic foot ulcers according to Wagner's classification of
ulcers is essential for inter-clinician communication, assessment of healing tendency during
management by NPWT.
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