scholarly journals Negative pressure wound therapy use in diabetic foot syndrome-from mechanisms of action to clinical practice

2019 ◽  
Vol 49 (4) ◽  
pp. e13067 ◽  
Author(s):  
Sebastian Borys ◽  
Jerzy Hohendorff ◽  
Claudia Frankfurter ◽  
Beata Kiec-Wilk ◽  
Maciej T. Malecki
Keyword(s):  
Clinical Practice ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Mechanisms Of Action ◽  
Diabetic Foot Syndrome ◽  
Wound Therapy

scholarly journals Use of Negative Pressure Wound Therapy after Endovascular Revascularization in a Patient with Diabetic Foot Syndrome Complicated by Sepsis

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Krzysztof Karaś ◽  
Krzysztof Wachal ◽  
Tomasz Kościński ◽  
Grzegorz Oszkinis
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Diabetic Foot Syndrome ◽  
Wound Therapy ◽  
Endovascular Revascularization

Pacjent lat 60, przyjęty do szpitala z powodu ostrego niedokrwienia kończyny dolnej prawej z martwiczymi zmianami po stronie grzbietowej i zewnętrznej stopy. Zmiany martwicze o szybko postępującym charakterze - owrzodzenia III/IV stopień według klasyfikacji Wagnera. Pacjent choruje na cukrzycę typu drugiego oraz na nadciśnienie tętnicze. Chory pali papierosy w ilości 1,5 paczki dziennie od 40 lat, prowadzi siedzący tryb życia. Leczenie zachowawcze polegało na miejscowym zastosowaniu maści z antybiotykiem o szerokim spektrum działania. Chorego poddano operacji rewaskularyzacyjnej i leczeniu opatrunkiem podciśnieniowym. Niewłaściwa pielęgnacja opatrunku V.A.C. i niekorzystne warunki zewnętrzne w oddziale chirurgicznym przyczyniły się prawdopodobnie do rozwoju zakażenia miejscowego i posocznicy co w konsekwencji było przyczyną amputacji kończyny.

Negative-pressure wound therapy and diabetic foot in the treatment of diabetic foot syndrome

Leczenie Ran ◽  
2014 ◽  
Vol 11 (1) ◽  
pp. 5-9
Author(s):  
Beata Mrozikiewicz-Rakowska ◽  
Adriana Nowak ◽  
Ewelina Bucior ◽  
Joanna Kania ◽  
Karolina Głodała-Jakoniuk ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Diabetic Foot Syndrome ◽  
Wound Therapy

scholarly journals Negative pressure wound therapy compared with standard moist wound care on diabetic foot ulcers in real-life clinical practice: results of the German DiaFu-RCT

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e026345 ◽  
Author(s):  
Dörthe Seidel ◽  
Martin Storck ◽  
Holger Lawall ◽  
Gernold Wozniak ◽  
Peter Mauckner ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Wound Care ◽  
Secondary Outcome ◽  
National Study ◽  
Wound Therapy ◽  
Closure Rate

ObjectivesThe aim of the DiaFu study was to evaluate effectiveness and safety of negative pressure wound therapy (NPWT) in patients with diabetic foot wounds in clinical practice.DesignIn this controlled clinical superiority trial with blinded outcome assessment patients were randomised in a 1:1 ratio stratified by study site and ulcer severity grade using a web-based-tool.SettingThis German national study was conducted in 40 surgical and internal medicine inpatient and outpatient facilities specialised in diabetes foot care.Participants368 patients were randomised and 345 participants were included in the modified intention-to-treat (ITT) population. Adult patients suffering from a diabetic foot ulcer at least for 4 weeks and without contraindication for NPWT were allowed to be included.InterventionsNPWT was compared with standard moist wound care (SMWC) according to local standards and guidelines.Primary and secondary outcome measuresPrimary outcome was wound closure within 16 weeks. Secondary outcomes were wound-related and treatment-related adverse events (AEs), amputations, time until optimal wound bed preparation, wound size and wound tissue composition, pain and quality of life (QoL) within 16 weeks, and recurrences and wound closure within 6 months.ResultsIn the ITT population, neither the wound closure rate (difference: n=4 (2.5% (95% CI−4.7% – 9.7%); p=0.53)) nor the time to wound closure (p=0.244) was significantly different between the treatment arms. 191 participants (NPWT 127; SMWC 64) had missing endpoint documentations, premature therapy ends or unauthorised treatment changes. 96 participants in the NPWT arm and 72 participants in the SMWC arm had at least one AE (p=0.007), but only 16 AEs were related to NPWT.ConclusionsNPWT was not superior to SMWC in diabetic foot wounds in German clinical practice. Overall, wound closure rate was low. Documentation deficits and deviations from treatment guidelines negatively impacted the outcome wound closure.Trial registration numbersNCT01480362and DRKS00003347.

scholarly journals Modern alternative or first-line treatment: How to safely use Negative Pressure Wound Therapy in Diabetic Foot Syndrome?

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Beata Mrozikiewicz-Rakowska ◽  
Ewelina Bucior ◽  
Joanna Kania ◽  
Adrianna Nowak ◽  
Marek Chojnowski ◽  
...  
Keyword(s):  
Side Effects ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Science Studies ◽  
Treatment Method ◽  
Diabetic Foot Syndrome ◽  
First Line ◽  
Wound Therapy ◽  
Wound Debridement

Clinical experience and basic science studies show that Negative Pressure Wound Therapy (NPWT) is a promising yet still under-used treatment method for patients with diabetic foot syndrome (DFS). Despite its advantages, it may carry the risk of serious side effects if the indications and contraindications are not strictly observed. The aim of this article is to discuss myths and facts about NPWT in conditions such as: inadequate blood supply, insufficient wound debridement, osteomyelitis or the necessity to monitor laboratory parameters during the therapy. We will try to define the optimal conditions for NPWT in order to obtain better results and eliminate the risk of side effects.

scholarly journals EFFECT OF SUBATMOSPHERIC NEGATIVE PRESSURE ON BIASED pH CHANGES IN PURULENT NECROTIC DEFECTS IN DIABETIC FOOT SYNDROME

2019 ◽  
Vol 19 (2) ◽  
pp. 26-30
Author(s):  
O.O. Kizimenko
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Diabetic Foot Syndrome ◽  
Vacuum Therapy ◽  
Second Phase ◽  
Wound Therapy ◽  
Ph Changes ◽  
Therapy Efficacy

The number of patients with diabetes mellitus worldwide is increasing with geometric progression, and thus there is an increase in the percentage of related complications. Diabetic foot syndrome is one of the most serious chronic complications that often results in early disability, long stretches of hospitalization, mounting expenses, and an amputated limb. At present, vacuum therapy in the treatment of purulent necrotic lesions of diabetic foot syndrome is being successfully used in medical practice. The aim of our study was to search and verify for indirect methods of express control of the vacuum therapy efficacy. Based on applying our patented local treatment technique, which includes the negative pressure wound therapy, we determined the pH dynamic changes and the monitored the microbiological climate of wounds. According to the results obtained, the high efficacy of the proposed technique has been found out and statistically confirmed. Starting from the 4th day of applying this technique, the main group demonstrated induced, significantly accelerated pH changes in the wounds that create the conditions for early growth of granulation tissue; the reduction of microbial load in the wound indirectly enhances these processes that were found out twice as slow in the comparison group. Therefore, the contact pH monitoring of wound is quite helpful for checking the therapy efficacy as well as for predicting the course of wound healing. Our study has confirmed its effectiveness in pH changing that positively affects the course of wound healing. Applying negative pressure wound therapy as an integral component of combined treatment of purulent necrotic lesions of diabetic foot syndrome allows medical practitioners to accelerate pH changes to reach their optimum values and considerably promotes the beginning of the second phase of wound healing. The study has also proven the enhanced elimination of bacterial agents from the wound by using this technique that also promotes the early activation of the phase 2 and significantly reduces the percentage of suppurative complications in the future.

Autologous fat grafting combined with negative pressure wound therapy in severe diabetic foot ulcer: a case study

2021 ◽  
Vol 30 (Sup4) ◽  
pp. S38-S40
Author(s):  
Zheng Biyao ◽  
Xu Gang ◽  
Jiang Hai ◽  
Duan Chenwang ◽  
Liu Xuan
Keyword(s):  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Foot Ulcer ◽  
Fat Grafting ◽  
Autologous Fat Grafting ◽  
Wound Therapy ◽  
Autologous Fat ◽  
Split Thickness Skin Grafting

Objective: Hard-to-heal wounds are a surgical challenge, and diabetic foot ulcers (DFUs) are one of the most common and severe varieties. Previous studies have shown that autologous fat grafting (AFG) and negative pressure wound therapy (NPWT) have the potential to promote wound healing. This case study describes how these two methods together helped in the healing of a serious DFU. Case history: A 65-year-old female patient had a severe DFU on her right foot, with a 30-year history of disease and renal failure. By the time symptoms were evident, regular dressing changes and antibiotic treatment were inadequate. She received surgical debridement, AFG and NPWT. Finally, as the granulation tissue covered the full wound bed, the wound was closed by split-thickness skin grafting. One month later, the DFU was fully healed with no recurrences. Conclusion: The application of AFG or components of adipose tissue to treat hard-to-heal wounds has been researched at both the molecular level and in clinic. In this case, we have proved the curative effect of jointly using AFG and NPWT.

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