Long-term negative pressure wound therapy decreases a risk of diabetic foot amputation assessed in the university of Texas wound classification

Abstract

Background

The University of Texas Wound Classification is a tool assesing risk of amputation of patients with Diabetic Foot Ulceration (DFU). Negative Pressure Wound Therapy (NPWT) is a nonivasive system which was shown to be effective in healing chronic wounds. The aim of the study was to assess utility of long-term NPWT in healing diabetic foot wounds among Polish patients with diabetes.

Material & Methods

In the study, we retrospectively analysed data of patients of DFU ambulatory using NPWT. Collected data included sex, age, type of DFU, duration of NPWT, history of previous minor amputation and characteristic of the healed wound in The University of Texas Wound Classification before and after NPWT.

Results

Total number of participants counted 21 (male = 16, 76%). The wound significantly improved in 17 (81%) patients. Group with successful treatment reached median 92% decrease of risk of amputation (-8.5 to -92%; p < 0.001). Group with successful treatment differed from group with unsuccessful treatment in count of angiopathic DFU (Chi2, 4[24%] vs. 3[75%]; p = 0.049). No significant differences in age, sex, history of previous minor amputation, presence of infection, depth of the ulcer were found. No NPWT adverse effect were reported. Logistic regression model revealed significant relationship between unsuccessful outcome of NPWT and presence of ischemic ulcer adjusted to presence of infection, depth of a wound and sex (OR = 27.5; CI: 1.1–716.7; p = 0.046).

Conclusions

NPWT significantly decraeses risk of amputation in Texas Score. NPWT may not help in healing wounds simultaneously infected and ischeamic. Presence of ischemic wound decreases chance for successful outcome.