Rumman Khan, Abdul Majeed, Noor Sardar.
Thirty Days in-Patient Outcome of Negative Pressure-therapy in Chronic Non-Healing Ulcers: (A Kaplan-Meier Analysis).
Ophthalmol Update Jan ;15(2):146-50.

Background: Chronic non-healing ulcers pose a significant surgical problem in surgical practice as well as in plastic surgery clinics. Significant advances have been made during the past decade with the introduction of negative pressure wound therapy. Objectives: To analyse thirty-day in-patient outcome of negative pressure therapy in chronic non-healing ulcers. Methods: This is a prospective observational study of three years between July 2013 and June 2016. We included 42 patients, in which 32 were diabetic foot ulcers while 10 were chronic venous ulcers. All patients failed conventional therapy including eusol therapy, gauze treatment along with bacterial sensitivity guided antibiotics therapy. Patients with known lower limb ischaemia, coagulation disorders and malignant ulcers were excluded. Vacuum assisted closure was applied, the dressing was renewed and wound evaluated for granulation or healing every three days. Patients either went to split skin grafting or secondary healing. Results: The mean age was 52.9 � 6.6 years with a mean symptoms duration of 12.8 � 17.08 months. There were 22 (52.4%) males and 20 (47.6%) female patients. The mean ulcer diameter at the start of negative pressure therapy was 6.6 � 1.3 cm. 18 (42.9%) ulcers were superficial (not exposing underlying bone) while 24 (57.1%) ulcers were deep (exposure of muscles and bone). Patients with diabetic foot ulcers had a median time to a favourable response of 21.0 (95% CI, 18.9 to 23.05) days. On the other hand, venous ulcers responded in a median time of 25.0 (95% CI, 23.4 to 26.5) days. Conclusions: The response to negative pressure therapy is quick and ulcers regress in size after at least two weeks of therapy. It is of particular importance in ulcers which may need grafting once the wounds are granulating.

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