Vacuum assisted closure (VAC) therapy was compared to conventional dressings for managing diabetic foot ulcers in a randomized controlled study. Results showed that VAC therapy led to faster wound healing and granulation tissue formation. By week 2, more wounds treated with VAC showed decreased discharge compared to conventional dressings. By week 6, all wounds treated with VAC showed full granulation versus only 55% for conventional dressings. VAC therapy also resulted in higher wound healing success rates of 100% compared to 63% for conventional dressings. The study concluded that VAC therapy is more effective, safe and patient-friendly than conventional dressings for treating diabetic foot ulcers.

1. Effectiveness of vacuum assisted
closure versus Surgical
Debridement in the management
of Diabetic foot ulcer
Ghanshyam Parmar kamlesh Vegad

2. INTRODUCTION
 Diabetic foot is the single most and
distressing complication of diabetes,.
 4-10%;
more common in elder patients
 Maximun will be cured but 10-15% will
stay vigorous, and 5-24% will lead to limb
amputation within a period of 6-18 months
following the first assessment.

3. • Many treatments available
• 1/superior moist wound therapy (AMWT) ,
• 2/bioengineered tissue or skin substitutes , growth factors
[8,9], electric. stimulation, and negative pressure wound
therapy (NPWT) .
• Management success depends on ulcer chronicity,
• patient execution and
• suitable off-load of the attachment.
• NWT generates a restricted controlled sub atmospheric
(negative) pressure surroundings. It encourages wound
healing by deferred primary or secondary purpose through
producing a damp wound environment, organizing the wound
bed for closure and promoting configuration and perfusion of
granulation tissue
• . Vacuum-assisted closure therapy is designated for utilize in
Severe care settings and for a diversity of wound types with
diabetic foot ulcers

4. AIM
• The aim of present research was to evaluate
the efficacy of vacuum-assisted closure (VAC)
against surgical debridement in diabetic foot
ulcerations (DFUs) in stipulations of healing
rate, protection, and patient happiness.

5. MATERIALS AND METHODS
• Present prospective randomized case-control study was conducted in the department of General
surgery at a tertiary care hospital in Kutch, Gujarat, India. Total 46 patients had participated in the
study.
• Prior to beginning of the treatment, informed consent was acquired from all of the participants and
an institutional ethical team accepted the research.
• The participants included patients with DM aged 18-75 years, with stage 2 or 3 DFU (as defined by
Wagner's classification)
• separated into Group A (patients treated with VAC) or Group B (patients treated with conventional
dressings), having equal Patients.
• Exclusion criteria were age of patients smaller than eighteen years, patients having pregnancy and
patients with foot ulcers further than diabetes.
• A thorough history, clinical examination and pertinent investigations were performed in all patients.
• Wounds of all participants undergo prickly surgical debridement; involved the removal of all
necrotic and impure tissue until vigorous, hemorrhagic tissue was attained .
• After debridement in group A, sterile, polyurethane foam dressing was positioned into the wound
defect. Lastly, negative pressure was given to the wound.

6. CONTD
• Group B established one time every day saline drenched gauze
dressing
• At each dressing change, the wound was cautiously evaluated to
conclude if the wound was well, dirt free and granulating.
• Following each 3 days, cultures were taken from the bottom of the
ulcer to evaluate for the bacterial flora. Ulcers were managed
waiting the wound was clogged impulsively, surgically or awaiting
achievement of 8-week era, whatever comes prior
• A concluding debridement and decontamination of the wound was
carrying out in the operating room before the surgical process.
• Treatment product was evaluated as time in use or manifestation of
granulation tissue.
• Treatment achievement was distinct as manifestation of granulation
tissue in a period of 8 weeks and collapse, as non manifestation of
granulation tissue 8 weeks or the require for amputation.

7. Statistical Analysis
• The data was coded and entered into
Microsoft Excel spreadsheet. Analysis was
done using SpSs version 15 (SPSS Inc. Chicago,
IL, USA) Windows software program.
• The variables were assessed for normality
using the Kolmogorov-Smirnov test.
Descriptive statistics were calculated.

8. Results
• The patient's age was among 35 and 75 years in Group A with a mean age of 56.47
years and between 38 and 69 years in Group B with a mean age of 54.36 years
(Table 1).
• Men constituted 84% and women around 16% in each group.
• During Week 2, wound discharge disappeared in 8 cases of Group A versus none
in the control group.
• Wound discharge moved out in 2 patients in Group A and 8 in Group B in Week 8.
• Granulation tissue emerged in 16 patients by the finish of Week 2 whereas it
emerged in 8 patients in Group B.
• Hundred percent granulation was accomplished in every participants by the finish
of Week 6 in Group A compared to barely 55% participants via time in Group B and
it was significant statistically (p <0.05).
• Wound dimension reduced in 20 patients in Group A as compared to 13 patients in
Group B.
• Management was flourishing in 100% of patients in Group A and 63% of patients
in Group B, difference between both groups was significant statistically (P<0.05).

9. Age Group Group A Group B
35-45 4 2
46-55 8 10
56-65 9 9
66-75 2 2
TOTAL 23 23
Table 1

10. Table 2
week Group A Group B
Week 2 16 8
Week 3 2 2
Week 4 1 1
Week 5 2 2
Week 6 2 2
Week 7 0 2
Week 8 0 3
Never during treatment 0 3

11. CONCLUSION
• VAC therapy is functional in the healing of
diabetic foot infections, which after
debridement, may present with exposed
tendon, fascia or bone . Debridement is
gravely significant to the beginning of healing.
VAC emerges to be extra effectual, secure and
patient suitable contrast to conventional
dressings for the management of diabetic foot
ulcers