Foot ulcers are serious complication of Diabetes Mellitus and are known to be resistant to conventional treatments. They may end in severe complications like amputations if not treated wisely at the earliest. Foot ulcers affect 10-25% of Diabetic patients. Management of a Diabetic Foot Ulcer (DFU) is often a challenging problem. Healing of these ulcers often takes a long time and may need one or more methods of treatment. In particular Vacuum assisted wound closure (VAC) therapy has gained popularity for treatment of chronic and complex wounds in patients with Diabetes.
Aims and Objectives: To evaluate the efficacy of vacuum assisted wound closure (VAC) therapy for the treatment of diabetic foot ulcers.
Materials and Methods: This is a prospective observational study done in Department of Plastic Surgery in Rajah Muthiah Medical College, Annamalainagar, Chidambaram from January 2016 – December 2018 with a total of 30 patients with diabetic foot ulcers. All these patients after admission were started on medical treatment for control of diabetes and antibiotics for infection. They were subjected to wound debridement followed by VAC dressing. The VAC dressing was continued till the ulcer bed developed healthy granulation tissue and ready for definitive procedure like grafting or flap cover. Initial wound surface area and the resultant wound surface area after VAC therapy, duration of hospital stay and procedure done for DFU’s were recorded and statistical analysis was done using paired ‘T’ test to compare wound surface area before and after VAC therapy.
Result: This study showed that mean initial wound surface area of 30 patients before VAC therapy was 103.07 cms and after VAC therapy there was significant reduction in wound size to 94.53 cms over a mean duration of 31.9 days. There was statistically reduction in wound size of 9.53 cms. This significantly increased the wound bed granulation tissue and good percentage of graft and flap take up. The daily requirement of antibiotic and analgesic was also reduced. Duration of hospital stay was also reduced due to faster wound healing. There was overall reduction in pain and further complications like amputations were avoided thereby increasing the patients compliance.
Conclusion: VAC therapy is newer and a safe method of treatment for Diabetic Foot Ulcers. There is faster wound healing, good graft and flap take with minimal or no complications.