Outcomes of Infected Diabetic Foot Ulcer with the Use of Vacuum-Assisted Closure(VAC) Therapy

Background: Wound healing problems in diabetic foot are mainly due to infection and poor tissue perfusion. In clinical practice many wound are slow to heal and difficult to manage.Vacuum-assisted closure (VAC) has proven to be effective in the wound management of soft tissue loss from infections. The purpose of this study is to examine the outcomes of VAC therapy used in the treatment of infected diabetic foot ulcer wounds.

Materials & Methods: We reviewed the medical records of thirty-eight with infected wound caused by diabetic foot ulcer, admitted to the Foot & Ankle and diabetic foot clinic, Severance Hospital, Yonsei University, Seoul, Korea, during the 20 months period April, 2006 to December, 2007.

Results: There were more males than females (M: F = 30:8); the mean age was 61.32±13.07 years (range 28 - 88). The mean length of prevalence was 17.76±8.67 years (range 1-30).  The left side foot (n = 22) was the most commonly involved, followed by right side foot (n = 15), and both foot (n=1). The mean length of using VAC was 29.24±27.47 (range 5-156) days. Wound healed at the level of debridement without the need for further bony resection (n=28) and Skin graft was performed in two patients. Long-term healing outcomes were excellent. The remaining (n = 10) went on to higher level amputation. The mean length of hospital stay was 50.9 ± 35.6(range 10 -149) days. Healing difference was seen significantly sex (p<0.027), age (p<0.003), location of foot (p<0.009), level of education (p<0.032). No difference was seen in mean length of using VAC, hospital length of stay, smoking. Prevalence length of diabetes mellitus (p=0.05).

 Conclusions: Promising results have been reported with vacuum-assisted closure (VAC) therapy in patients with infected diabetic foot ulcer. The applications are for salvage of feet or as an adjuvant therapy to improve results of various wounds.