Vacuum Assisted Closure vs. Conventional Therapy in Diabetic Foot: A Comparative Study

Abstract

Background: Diabetic foot ulcers (DFUs) represent one of the most challenging complications of diabetes mellitus, often leading to prolonged morbidity, disability, and increased healthcare costs. Conventional wound care remains the mainstay of treatment, but limitations in healing efficacy necessitate adjunctive therapies. Vacuum-assisted closure (VAC), also known as negative pressure wound therapy, has gained attention as a potential modality to accelerate wound healing and improve outcomes.

Objective: To compare the efficacy of VAC therapy versus conventional wound management in patients with Wagner’s grade I and II diabetic foot ulcers.

Methods: This prospective comparative study was conducted at Hayatabad Medical Complex, Peshawar, from July to September 2024. A total of 62 patients with type II diabetes mellitus and Wagner’s grade I–II DFUs were randomized into two groups: Group A (VAC therapy, n=31) and Group B (conventional therapy, n=31). Outcomes assessed over four weeks included pain severity (VAS), ulcer size reduction, granulation tissue formation, complete wound healing, time to healing, and surgical debridement requirement.

Results: VAC therapy significantly improved pain relief and ulcer size reduction compared to conventional therapy (p<0.001 for both). Median VAS score was lower in Group A (3 vs. 7), and mean ulcer size was smaller at four weeks (11.6 ± 1.2 cm² vs. 13.4 ± 1.1 cm²). However, no statistically significant differences were observed in granulation tissue scores, Wagner’s grade improvement, complete healing rates, healing time, or debridement requirements.

Conclusion: VAC therapy provides superior short-term benefits in pain reduction and ulcer size shrinkage compared to conventional management, though its impact on complete healing requires further investigation.