CS14-022 Single use negative pressure therapy following surgical debridement of a diabetic foot ulcer

Dave Brett, BS, BS, MS, Clinical Affairs, Smith & Nephew, St. Petersburg, FL
Objectives:  To treat a diabetic foot ulcer post debridement and create conditions necessary to facilitate wound healing.

Methodology: Male, late forties, Type I diabetes. Initially admitted to hospital with injuries sustained when a horse stood on his right foot.  A conservative approach was implemented, but post-discharge the condition of the foot deteriorated due to infection which prompted an emergency re-admission and antibiotic therapy. Single-use NPWT (SUNPWT) was commenced 8-days post-surgical debridement at which time the wound bed comprised a mixture of slough and granulation tissue and the wound was producing moderate amounts of exudate.


Key results:

Day 5

The condition of the wound had improved with healthy granulation tissue now comprising the greatest proportion of the wound bed. With SUNPWT the wound dimensions had reduced considerably with the wound now measuring 70 mm in length, 22 mm wide with a depth of 5 mm (wound area of 1210 mm2; wound volume 4032 mm3). This change in wound dimensions represented a 12% reduction in wound area and a 44% reduction in wound volume.

Day 12

The wound width had now reduced to 16 mm, whilst granulation had now reached the level of the surrounding skin (wound area 880 mm2). With granulation tissue now filling the wound to the level of the peri-wound skin SUNPWT was discontinued since the treatment objective had been achieved. Over the 12 day treatment period the wound area reduced by 36%, from an intial 1374 mm2 to 880 mm2.   The wound continued to progress towards healing with conventional advanced wound management and ultimately healed in a timely manner.

Conclusions:  The small device size, simplicity of application and lower unit cost compared with conventional systems raises the possibility that SUNPWT could make NPWT accessible to patients for whom conventional canister-based NPWT would not be appropriate or affordable.