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العنوان
Comparative Study between Negative Pressure Wound Therapy (NPWT) and Standard Moist Wound Dressing (SMWD) In Management of Diabetic Non-Ischemic Foot Ulcers
الناشر
faculty of medicine
المؤلف
Zekri,Mina Gamil
هيئة الاعداد
باحث / مينا جميل ذكري
مشرف / الأستاذ الدكتور/ علي صادق صبور
مشرف / الأستاذ الدكتور/مصطفي سليمان محمود
مشرف / الأستاذ الدكتور/ احمد فاروق عبد المحسن
تاريخ النشر
2019
عدد الصفحات
130 P.:
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
جراحة
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - جراحة الاوعية الدموية
الفهرس
Only 14 pages are availabe for public view

from 130

from 130

Abstract

Background: Diabetic Foot Ulcer(DFU) is a common complication of diabetis that has shown an increasing trend over previous decades, 15% of patients with diabetes will suffer from DFU. and approximately 20% of hospital admissions among patients with DM are the result of DFU. Standard moist wound dressing (SMWD) is considered the traditional method for management of DFU. Supporting evidence for NPWT in the treatment of diabetic foot wounds include numerous prospective and multi-centered randomized controlled trials. Aim of the Work: This study aimed to compare wound outcome, limb salvage between NPWT and SMWT in management of diabetic non ischemic foot ulcers. Patients and Methods: This is a randomized controlled study involving 60 patients with active diabetic foot ulcers. A computer generated randomization pattern was used to segregate the patients into 2 groups (NPWT and SMWD groups). Primary end point of the study was to achieve full healthy granulating wound (without necrotic tissues, bone or tendon exposure and without local signs of infection). follow up included change in wound diameter, depth, up or down scaling along UTWC, wound status every 2 weeks. Results: there was a statistically significant difference in rate of depth improvement for the NPWT group in 2 and 4 weeks. In six weeks follow up, the rate of depth reduction was better in NPWT group but it wasn’t statistically significant (p-value 0.14). There was a statistically significant difference in reaching full healthy granulation in 4 and 6 weeks in favor of the NPWT group compared to the SMWD, there was no statistically significant difference in number of cases reaching full healthy granulation in 8 weeks as many cases of SMWD group started to achieve full healthy granulation. Number of bed side debridement or surgical debridement was not statistically significant between the 2 groups. major amputation was seen in 4 cases of the SMWD group, and one trans-metatarsal amputation and 2 toes amputation was seen in NPWT group and none of these was statistically significant. Conclusion: NPWT use in DFU provides a significant reduction in duration till reaching full healthy granulation. No significant difference was observed in ulcer related complications such as infection, cellulitis, and osteomyelitis. However, the study showed that SMWD patients had more secondary amputations than those receiving NPWT but it wasn’t statistically significant