Title: Negative pressure wound therapy in patients with diabetic foot in Peru

Biography:

Yudith Quispe Landeo has her expertise in evaluation and managing patients with diabetic foot ulcers. She is the President of the Alliance for the Salvatage of Diabetic Foot Perú. She has years of experience in teaching in different universities and actually she is developing a research work with national impact, calling for participation of representatives of the different regions of Perú. She is a member of the American Diabetes Association and the Latinoamerican Diabetes Association (ALAD). She has master studies in teaching and research in health and doctorate in medicine. I don`t have conflicts of interest.

Abstract

The wound management involves a comprehensive assessment of the patient and the wound to determine an optimal treatment plan. It is critical to identify and address factors that may impair wound healing, prior to selecting the most appropriate therapy for each patient. Negative pressure wound therapy (NPWT) is a well-established advanced therapy that has been successful in adjunctive management of acute and chronic wounds According Si Liu Chao-zhu He, eleven controlled randomized studies, that included 1,044 patients, from 691 identified studies, concluded that NPWT had higher rates of complete healing than standard dressings. From January to December 2018 we chose forty patients in our institution to receive NPWT as a adjunctive management. Twenty four patients (60%) had neuropatic foot, twelve patients (30%) had neuroischemic foot and four patients (10%) had ischemic foot. The mean wound depth at the beginning of the treatment was 3 cm and the mean area 20 cm2. Before the beginning of the NPWT, the lesions must show a transcutaneous oximetry (TCPO2 )greater than 40 mmhg in the neuroischemic and ischemic group. Some lesions had bone exposure and some tendons. We changed dressings in these patients six times as a mean, with a three –day interval. Granulation tissue formation in 90 % of the wound area and  a reduction of 80% of the wound depth were the criteria for good clinical response.  100% of the neuropatic group and 75% of the neuroischemic group reached the criteria described previously. On the other hand, only 25% (one patient) of the ischemic group reached these conditions and underwent amputation of the limb. Mild pain was the commonest symptom (20%). We didn´t find bleeding and infection signs in our patients chosen for NPWT.

Conclusion: Negative Pressure wound therapy is a very useful tool used in complex wounds in diabetic population.