A retrospective, descriptive observational study on the use of negative pressure wound therapy with instillation and dwell time (NPWTi-d) in the management of infected diabetic foot ulcers

What is it about?

Background Diabetic foot ulcers (DFU) are a major health concern globally due to their high risk of infection, amputation and associated healthcare burden. Negative pressure wound therapy with instillation and dwell time (NPWTi-d) has emerged as a promising adjunctive treatment for infected DFUs, especially when integrated into multidisciplinary care pathways. Aim This study aimed to evaluate the clinical outcomes of NPWTi-d in the management of infected DFUs within a multidisciplinary team (MDT) setting in a tertiary hospital in Singapore. Methods A retrospective, descriptive observational study was conducted involving 50 patients with infected DFUs treated with NPWTi-d (V.A.C. Veraflo™) following surgical debridement between January 2021 and June 2022. Patient demographics, wound characteristics, treatment timelines, and outcomes were extracted from a chronic wound registry and electronic medical records. Descriptive statistical analysis was performed using JMP® software. Results Of the 50 patients included, 90% (n=45) achieved complete wound healing. The majority (88%, n=40) underwent successful closure via reconstructive surgery, while none required major amputation. The median length of stay was 20 days, and the mean number of operative visits was four. More than half of the patients (52%, n=26) underwent minor amputations, primarily ray amputations and toe disarticulations. Conclusion NPWTi-d, when applied post-debridement and supported by MDT care, appears to be effective in achieving high wound healing rates and facilitating limb preservation in patients with infected DFU. Implications for clinical practice These findings support the integration of NPWTi-d into MDT pathways for early and effective management of infected DFU. Further prospective comparative trials are warranted.

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