Improved Post Hospitalization Healing of an Infected Diabetic Foot Ulcer using a Disposable Portable Negative Pressure Wound Therapy in an Unfunded Patient

Background

The prevalence of diabetes in the United States is 7.8% of the population or 23 million people. The rate of lower extremity amputation for patients with diabetic ulcers is 25%, due to poor healing and high rates of complications. (Driver, V., Lebretton, J. Landowski, M.A, & Madsen, J.L. 2011). Negative Pressure Wound Therapy (NPWT), is the application of sub atmospheric (negative) pressure to a wound through suction to facilitate wound healing. It is considered an adjunct therapy in the treatment of diabetic foot ulcers by accelerating wound closure. (Nain 2011).

The maintenance of a seal with the dressing application is the most crucial component of a negative pressure wound therapy system. A leak in the seal can lead to failure of the treatment.

Purpose

To describe a case study on the innovative use of a disposable portable NPWT system. The selection of this NPWT was based on a combination of patient variables and this system’s unique features.

Method

A diabetic patient presented status post amputation of the 3^rd and 4^th metatarsals of the right foot. She has a history of noncompliance with previous treatments including antibiotics, glycemic control, and off-loading. A case study describing the NPWT system’s effects on wound closure and a Step by Step pictorial training for the staff was implemented and evaluated for positive outcomes.

Findings

Wound closure was achieved in 55 days. Training of the wound care staff increased dressing application proficiency. The patient verbalized satisfaction with ease of use.

Conclusion

The best practices of the wound care team resulted in the following:

1.  Timelier wound closure of a diabetic ulcer.
2.  Utilized the full expertise of nurses in obtaining positive results.
3.  Improved patient compliance and mobility.
4.  Decreased nursing visits and supplies improving cost containment measures in an unfunded patient.