Scholarlink

Background <p>To explore the efficacy, safety, and cost implications of NPWT versus standard wound care (SWC) for Diabetic Foot Ulcers (DFUs).</p> Methods <p>91 patients with DFUs were included in this retrospective study from May 2017 and February 2024. All patients were divided into NPWT (<i>n</i> = 44) and SWC (<i>n</i> = 47) groups based on the surgery methods. Arterial disease severity was assessed via ankle-brachial index (ABI) and Doppler ultrasound, with subgroups categorized as severe ischemia (ABI &lt; 0.4), moderate ischemia (ABI 0.4–0.7), and normal/mild ischemia (ABI &gt; 0.7). Baseline characteristics, wound parameters, healing progression, adverse events, costs, and subgroup outcomes by arterial disease status were compared between two groups.</p> Results <p>At the 4-week assessment, the NPWT group exhibited significantly higher mean percentage reduction in wound area (35.01% vs. 32.53%, <i>P</i> = 0.033) and greater reduction in wound depth (2.74&#xa0;mm vs. 2.14&#xa0;mm, <i>P</i> = 0.032) compared to the SWC group. A notably higher proportion of NPWT patients achieved complete wound closure (52.27% vs. 27.66%, <i>P</i> = 0.029), resolution of infection (88.64% vs. 68.09%, <i>P</i> = 0.035), and neuropathy improvement (59.09% vs. 34.04%, <i>P</i> = 0.029). NPWT also showed lower wound infection rates (9.09% vs. 29.79%, <i>P</i> = 0.027) but higher skin irritation (31.82% vs. 10.64%, <i>P</i> = 0.026). Subgroup analysis revealed NPWT’s superiority in both PAD-positive (48.0% vs. 20.0%, RR = 2.40, 95% CI: 1.12–5.15, <i>P</i> = 0.042) and PAD-negative subgroups (55.2% vs. 30.4%, RR = 1.82, 95% CI: 1.05–3.15, <i>P</i> = 0.031). Even in severe ischemia (ABI &lt; 0.4), NPWT achieved higher closure rates (36.4% vs. 12.5%, <i>P</i> = 0.038). While total treatment costs were comparable (<i>P</i> = 0.084), NPWT reduced hospitalization days (16.05 vs. 21.38 days, <i>P</i> = 0.028) and drug costs (5229.33 RMB vs. 5915.5 RMB, <i>P</i> = 0.030).</p> Conclusion <p>NPWT is more superior in safety, cost-efficiency, and long-term wound management compared to SWC.</p> Trial registration <p>Not applicable.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Comparison and evaluation of negative pressure wound therapy versus standard wound care in the treatment of diabetic foot ulcers

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年5月15日

查看全文
  • Quan Guo

摘要

Background

To explore the efficacy, safety, and cost implications of NPWT versus standard wound care (SWC) for Diabetic Foot Ulcers (DFUs).

Methods

91 patients with DFUs were included in this retrospective study from May 2017 and February 2024. All patients were divided into NPWT (n = 44) and SWC (n = 47) groups based on the surgery methods. Arterial disease severity was assessed via ankle-brachial index (ABI) and Doppler ultrasound, with subgroups categorized as severe ischemia (ABI < 0.4), moderate ischemia (ABI 0.4–0.7), and normal/mild ischemia (ABI > 0.7). Baseline characteristics, wound parameters, healing progression, adverse events, costs, and subgroup outcomes by arterial disease status were compared between two groups.

Results

At the 4-week assessment, the NPWT group exhibited significantly higher mean percentage reduction in wound area (35.01% vs. 32.53%, P = 0.033) and greater reduction in wound depth (2.74 mm vs. 2.14 mm, P = 0.032) compared to the SWC group. A notably higher proportion of NPWT patients achieved complete wound closure (52.27% vs. 27.66%, P = 0.029), resolution of infection (88.64% vs. 68.09%, P = 0.035), and neuropathy improvement (59.09% vs. 34.04%, P = 0.029). NPWT also showed lower wound infection rates (9.09% vs. 29.79%, P = 0.027) but higher skin irritation (31.82% vs. 10.64%, P = 0.026). Subgroup analysis revealed NPWT’s superiority in both PAD-positive (48.0% vs. 20.0%, RR = 2.40, 95% CI: 1.12–5.15, P = 0.042) and PAD-negative subgroups (55.2% vs. 30.4%, RR = 1.82, 95% CI: 1.05–3.15, P = 0.031). Even in severe ischemia (ABI < 0.4), NPWT achieved higher closure rates (36.4% vs. 12.5%, P = 0.038). While total treatment costs were comparable (P = 0.084), NPWT reduced hospitalization days (16.05 vs. 21.38 days, P = 0.028) and drug costs (5229.33 RMB vs. 5915.5 RMB, P = 0.030).

Conclusion

NPWT is more superior in safety, cost-efficiency, and long-term wound management compared to SWC.

Trial registration

Not applicable.