The Clinical Efficacy and Cost Effectiveness of the Vacuum-Assisted Closure Technique in the Management of Acute and Chronic Wounds: A Randomized Controlled Trial

Braakenburg, Assa; Obdeijn, Miryam C.; Feitz, Reinier; Rooij, Iris A. L. M. van; Griethuysen, A. J. van; Klinkenbijl, Jean H. G.

doi:10.1097/01.prs.0000227675.63744.af

Cited by 273 publications

(187 citation statements)

References 17 publications

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“…22 Bacterial clearance was similar in both the groups, a tad better in conventional group (VAC : 80%, conventional : 83.3%) which is similar to certain studies but, in few other studies reduction in bacterial load was reported this can be due to improvement in circulation and oxygenation to compromised or damage tissue, which enhances the resistance to infection. 5,8,9,13,17,19,22 Increase in local tissue oxygen levels reduce or eliminate the growth of anaerobic organisms, which have been correlated to decreased healing rates. Also increased flux makes greater amounts of oxygen available to neutrophils for oxidative bursts that kill bacteria.…”

Section: Bacterial Clearancesupporting

confidence: 63%

A randomized controlled trial comparing low cost vacuum assisted dressings and conventional dressing methods in the management of diabetic foot ulcers

et al. 2017

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INTRODUCTIONIndia, is ranked first in the list of the ten nations most affected with diabetes, foot ulceration is the most common complication, affecting approximately 15% of diabetic patients during their lifetime. This can be attributed to several social and cultural practices such as barefoot walking, inadequate facilities for diabetes care and education, and poor socioeconomic conditions. 1 Diabetic foot ulceration followed by amputation contributes dramatically not only to the morbidity among persons with diabetes but is also associated with severe clinical depression. 2 ABSTRACTBackground: Diabetic foot ulcers are chronic wounds which are difficult to heal, due to ischemia and intrinsic defects in angiogenesis and impaired immunity against infection. VAC therapy influences positive mechanical forces on the growth of tissues, especially in stimulating cell migration and mitosis, optimizes blood flow, decreases local tissue edema from the wound bed and provides an occlusive environment for wound healing under moist, clean and sterile conditions. Aims and objective was to compare the effectiveness of low cost hospital made VAC dressing with conventional dressings in healing of diabetic foot ulcers. Methods: This study was a prospective, randomized controlled trial and included 60 patients with diabetic foot ulcers admitted over 3 months. Patients were randomly allocated to two groups: odd numbered patients to VAC therapy and the even numbered patients to conventional dressings. Wound swab was taken before the start of the study. The data was analyzed and presented in percentages or proportions using Chi-square test and Student-t-test wherever applicable. Results: In this study it was found that in the VAC dressing group 76.7% of the ulcers had red granulation tissue at the end of therapy compared to 46.7% in conventional group. The mean wound bed preparation time was found to be 15.60 days in the conventional dressing group and 8.50 days in the VAC therapy group. In the VAC group 72.73% ulcers had no bacteria at the end of therapy. Conclusion: In this study, it was found that Vacuum Assisted Closure therapy was more effective than conventional dressings in the wound bed preparation of diabetic foot ulcers.

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Section: Bacterial Clearancesupporting

confidence: 63%

A randomized controlled trial comparing low cost vacuum assisted dressings and conventional dressing methods in the management of diabetic foot ulcers

et al. 2017

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“…These results suggest that use of the SNaP Wound Care System can positively impact on the quality of life experienced by patients with chronic wounds. This reflects outcomes displayed in the literature regarding the effect of using TNP therapy on the quality of life of patients with wounds, 24,39 although the general consensus is that more research is required in this area. Results also need to be interpreted with caution as the CWIS has been validated to highlight changes in quality of life when performed at least 12 weeks apart, whereas here there was only a 6-week period between questionnaires.…”

Section: Evaluation Of a Novel Tnp Device In Healing Chronic Woundsmentioning

confidence: 93%

Clinical Evaluation of a Novel Topical Negative Pressure Device in Promoting Healing in Chronic Wounds

Bradbury

Walkley

Ivins

et al. 2015

Advances in Wound Care

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Aim: This observational study evaluated the use of a novel, ultraportable, mechanically powered topical negative pressure device in promoting healing in chronic wounds, including venous and mixed etiology leg ulcers and neuropathic foot ulcers. Materials and Methods: Evaluable patients (n = 37) received treatment with the SNaP Ò Wound Care System for up to 6 weeks. The primary objective was percentage change in wound size, with secondary objectives of clinical assessment of wound parameters, ease of use, and impact on quality of life. Results: A 42.64% mean percentage decrease in wound area was observed, with an overall decrease for each wound etiology subgroup. Increased granulation tissue, decreased exudate levels, and decreased wound pain were reported. Quality-of-life scores increased overall, and the device was easy to use, comfortable, portable, and inconspicuous.

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“…38 In a RCT with 65 cases Braakenburg et al reported similar overall costs. 40 In 2008, Apelqvist et al reported significantly lower costs in NPWT group vs. standard moist wound therapy of diabetic foot wounds (with average 12 852 $). 41 A systematic review of National Health Service of UK supported the usage of NPWT in chronic wound management due to better QoL and improved cost effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Negative pressure wound therapy versus healing by secondary intention in pressure ulcers

Cirocchi¹,

G²,

Mutafchiyski³

et al. 2017

NPWTJ

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REVIEWAbstract-: Pressure ulcers are a highly prevalent source of morbidity with an equally high incidence of up to 38.0% amongst different categories of healthcare institutions. Therefore, the management and therapeutic approach toward these often hospital-or facility-acquired problems remain critical aspects of long-term care. Negative pressure wound therapy (NPWT) has proven effective in addressing the barriers to pressure ulcer healing including increasing blood flow to previously ischemic wound areas by generating subatmospheric pressure which vacuums in circulation. The objective of this study was to compare negative pressure wound therapy (NPWT) versus surgical wounds healing by secondary intention (SWHSI). A systematic literature search was conducted using the PubMed and Scopus search engine up until the 20 Th January 2017 including the terms: "negative pressure wound therapy" and "pressure ulcers". In this systematic review, six randomized controlled trials were included. NPWT is deemed appropriate and effective method and widely used by clinicians to promote the healing of wounds and ulcers of different etiology. The heterogeneity found in individual trials regarding the inclusion criteria, therapeutic procedures, the criteria and methods of outcome evaluation, however, did not allow for a data evaluation with statistically valid conclusions. It is reasonable to assume that a subset of patients with pressure ulcers can be effectively treated with NPWT, with optimal results and good cost-benefit ratio, also with respect to the quality of life.

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The Clinical Efficacy and Cost Effectiveness of the Vacuum-Assisted Closure Technique in the Management of Acute and Chronic Wounds: A Randomized Controlled Trial

Cited by 273 publications

References 17 publications

A randomized controlled trial comparing low cost vacuum assisted dressings and conventional dressing methods in the management of diabetic foot ulcers

A randomized controlled trial comparing low cost vacuum assisted dressings and conventional dressing methods in the management of diabetic foot ulcers

Clinical Evaluation of a Novel Topical Negative Pressure Device in Promoting Healing in Chronic Wounds

Negative pressure wound therapy versus healing by secondary intention in pressure ulcers

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