Randomized Clinical Trial of Vacuum-Assisted Closure Versus Conventional Dressings in Patients with Diabetic Foot Ulcers

The objective of this study was to evaluate the comparative efficacy of vacuum-assisted closure (VAC) and conventional dressing methods in the management of diabetic foot ulcers. The assessment focused on specific parameters, including the rate of granulation tissue formation, the bacterial clearance upon completion of therapy, and the duration required for wound healing. This randomized comparative study was conducted in the Department of General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, from January 2021 to December 2022. Fifty patients with lower limb diabetic ulcers were included and randomized into two groups: conventional dressing (n = 31) and vacuum-assisted closure (VAC) dressing (n = 19). Patient outcomes after dressing were compared. Statistical analysis was performed using SPSS software, and a p value < 0.05 was considered statistically significant. Compared to conventional dressing, the vacuum-assisted closure (VAC) dressing group had comparable age, gender, and associated comorbidities (p value > 0.05). The VAC group exhibited a shorter, albeit comparable, duration for granulation tissue to appear (6.94 +/- 2.61 vs. 9.03 +/- 2.30, p value 0.29), a significantly shorter duration for wound culture to become negative (11.36 +/- 4.47 vs. 14.83 +/- 3.89, p value 0.037), and a significantly reduced duration for wound healing (36.84 +/- 9.34 vs. 43.16 +/- 9.22, p value 0.033). The present randomized study comparing vacuum-assisted closure (VAC) dressing with conventional dressing for diabetic foot ulcers, after controlling for several factors affecting wound healing in diabetes, demonstrated results favoring VAC.