Mechanically-Powered Disposable Negative Pressure Wound Therapy Use in Diabetic Foot Wounds

Abstract

Diabetic foot ulcers remain a major health care problem resulting in considerable suffering and substantial socioeconomic costs.1 The gold standard for diabetic foot ulcer treatment includes debridement, management of infection, revascularization procedures when indicated, and off-loading of the ulcer.2 Negative pressure wound therapy (NPWT) is routinely used as an adjunctive tool in complicated DFU management,3 however size, bulk, noise, and need for an electrical power source are all drawbacks of traditional NPWT devices.4 Patients with smaller-sized diabetic foot wounds may benefit from ultraportable, mechanically-powered disposable negative pressure wound therapy (dNPWT*) that may allow a quick return to activities of daily living while receiving the effects of NPWT.3,4 A retrospective data analysis was performed to determine outcomes of 3 diabetic patients with complicated foot wounds that were adjunctively treated with dNPWT following surgical intervention. Age of patients ranged from 46 to 71 years old. All wounds were debrided prior to dNPWT, and systemic antibiotics were administered as needed. Wound size ranged from 0.33 cm3 to 12.6 cm3. Disposable NPWT was applied with a foam dressing to each wound at -125 mmHg and changed 3 times weekly. Duration of dNPWT use ranged from 16 to 24 days, during which time drainage was controlled and robust granulation tissue formed in all wounds. Therapy was stepped down to oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressings** and the wounds healed secondarily. Use of mechanically powered dNPWT should be considered in smaller-sized DFUs to expedite wound bed preparation for secondary closure following surgical intervention.

* SNAP™ Therapy System (KCI, now part of 3M Company, San Antonio, TX)
** PROMOGRAN PRISMA™ Matrix (KCI, now part of 3M Company, San Antonio, TX)

References
1. Hogg FRA, Peach G, Price P, et al. Measures of Health-Related Quality of Life in Diabetes-Related Foot Disease: A Systematic Review. Diabetologia 2012 Mar;55(3):552-65
2. Doupis J, Veves A. Classification, diagnosis, and treatment of diabetic foot ulcers. Wounds. 2008;20:117–126.
3. Armstrong DG, Marston WA, Reyzelman AM, Kirsner RS. Comparative effectiveness of mechanically and electrically powered negative pressure wound therapy devices: a multicenter randomized controlled trial. Wound Repair Regen. 2012 May-Jun;20(3):332-41.
4. Lerman B, Oldenbrook L, Ryu J, et al. The SNaP Wound Care System: a case series using a novel ultraportable negative pressure wound therapy device for the treatment of diabetic lower extremity wounds. J Diabetes Sci Technol. 2010 Jul 1;4(4):825-30.

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