Abstract

Purpose: The purpose of this case study and evidence based literature analysis is to determine the effectiveness of negative pressure wound therapy (NPWT) versus advanced moist dressing therapy (MDT) for the treatment of diabetic foot ulcers (DFU). Background: With the current prevalence of diabetes reaching almost 30 million in the U.S., DFUs have become an increasingly major public health concern. Complications from DFU's lead to an increase in health care cost, decreased quality of life, and possible death in severe cases. The serious nature of the disease requires an effective treatment plan in order to optimally manage the healing of DFU's. The current standard of treatment includes the use of moist dressings, however, several studies suggest NPWT may be just as beneficial, if not more beneficial for the treatment of DFU's. Case Description: The patient for this case study is based on a thirty-two year old obese female admitted to University Medical Center (UMC) El Paso with a Wagner Grade 3 diabetic foot ulcer to the right metatarsal head, leading to osteomyelitis infection requiring amputation of the right hallux. This patient was historically non-compliant with managing her diabetes, and due to complications, had multiple admissions to UMC. This patient's course of treatment motivated an evidenced based analysis to answer the following PICO question: 'In patients with diabetic foot wounds, is negative pressure wound therapy more effective than advanced moist dressing therapy for promoting faster healing times and reducing secondary complications?' Outcomes: A review of current literature revealed several high quality studies addressing the use of NPWT in the treatment of DFU's. The overall quality of the current evidence is sufficient to answer the PICO question. Negative pressure wound therapy is a safe and effective treatment in the management of diabetic foot ulcers, resulting in better overall outcomes for the patient. Discussion: When compared to standard moist dressings, negative pressure wound therapy was found to have a similar safety profile. NPWT however, was found to have better outcomes in regards to proportion of healed ulcers, decreased healing time, greater granulation tissue formation, and decreased secondary amputations. Had this patient been initially discharged home with NPWT, she may not have been readmitted, and therefore had improved outcomes in terms of wound healing and better quality of life. Based on the current evidence, NPWT should be considered as a primary intervention in the treatment of diabetic foot ulcers. Further research is needed to determine optimal parameter settings for the negative pressure devices, and in order to develop a standardized protocol for the use of NPWT.

Provenance

Submitted by Heather Armijio (bheather@salud.unm.edu) on 2015-06-17T21:23:59Z No. of bitstreams: 2 Armijo Capstone.pdf: 1293036 bytes, checksum: db11acd594381482969facf0dfb30cb7 (MD5) Armijo Poster.pdf: 290164 bytes, checksum: cac4c847a4371a730bad283ea39fa081 (MD5), Made available in DSpace on 2015-06-17T21:23:59Z (GMT). No. of bitstreams: 2 Armijo Capstone.pdf: 1293036 bytes, checksum: db11acd594381482969facf0dfb30cb7 (MD5) Armijo Poster.pdf: 290164 bytes, checksum: cac4c847a4371a730bad283ea39fa081 (MD5) Previous issue date: 2015-06-17

Document Type

Capstone

Comments

Advisor: Fred Carey, PT. PhD

Keywords

NPWT & Diabetes, NPWT & Diabetic foot ulcers, NPWT & Moist dressing therapy, vacuum assisted closure

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