Negative pressure wound therapy for diabetic foot ulcers

Foot ulcers are a common complication in patients with diabetes. Patients with diabetes have impaired wound healing associated with a multitude of factors, including neuropathy, vascular disease, and foot deformities. At the cellular level, an increase in the number of acute inflammatory cells, absence of cellular growth, and migration of the epidermis have been observed. Negative pressure wound therapy (NPWT) is a wound care therapy that is being increasingly used in the management of foot ulcers. There are several small RCTs and two larger multicentre RCTs of diabetic foot ulcers. Negative pressure wound therapy seems to be a safe and effective treatment for complex diabetic foot wounds, and could lead to a higher proportion of healed wounds, faster healing rates, and potentially fewer re-amputations than standard care. No serious treatment-related complications were reported by any of the studies. Studies also reported an increase in granulation and wound-healing rates in patients treated with NPWT therapy. No data on patient satisfaction or experience were reported. However, the absence of evidence does not prove the absence of effectiveness ; the NPWT therapy may be more effective than conventional dressings.