Preliminary evidence using negative pressure wound therapy to achieve limb salvage for the ischemic diabetic foot

Abstract

Aim: Negative pressure wound therapy (NPWT) in diabetic foot ulcers (DFU) has been discussed in several studies, but without a focus on peripheral arterial disease (PAD), which is a common comorbidity. This study aims to investigate the feasibility of NPWT in the treatment of DFU with PAD in regards to limb salvage and the clinical course.

Methods: The authors retrospectively collected patients with DFU and PAD diagnosed with either Doppler ultrasound or angiography as the PAD study group. Patients with DFU but no PAD were enrolled as the non-PAD comparison group. NPWT was applied to both PAD and non-PAD subjects.

Results: There were 10 patients in the PAD group and 3 patients in the non-PAD group. In the PAD group, there was a 70% limb salvage rate with 14.70 (± 10.33) treatment days. The non-PAD comparison group had a higher limb salvage rate (100% vs. 70%, respectively), but a longer treatment time (30.00 vs. 14.70 days, P < 0.05, respectively) when compared to the PAD group. The 3 patients in the PAD group who failed limb salvage all had issues related to uncontrolled infection.

Conclusion: NPWT is a feasible adjuvant therapy for DFU in patients with PAD, with a 70% limb salvage rate. Prolonged treatment time was due to the initial severity of the subjects with multiple comorbidities. The main reason for limb loss was intractable infection.

Keywords

Negative pressure wound therapy / diabetic foot ulcer / peripheral arterial disease / limb salvage

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