NPWT: a gate of hope for patients with diabetic foot ulcers
Abstract
Non-healing diabetic foot ulcers are a common and costly complication of type 2 diabetes and can result in lower extremity amputation. This case study concerns a 51-year-old man with a 17-year history of uncontrolled type 2 diabetes. He had developed a deep ulcer to the calcaneus of his left foot, which was 12x7 cm in size and infected with multi-drug-resistant Staphylococcus aureus. He was admitted to hospital for the non-healing diabetic foot ulcer and uncontrollable fever and was a candidate for amputation. He was treated with wound irrigation and debridement as well as negative-pressure wound therapy and antibiotic treatment. This strategy was effective and the wound size reduced progressively. The patient recovered well. Medical and wound care teams who deal with non-healing diabetic foot ulcers can benefit from a strategy of combination therapy.
References
- A survey of lower limb amputation rate in patients with diabetes at Shahid Modarres Hospital, Tehran, Iran, during 5 years. J Anal Res Clin Med. 2017;5:78–81. https://doi.org/110.15171/jarcm.2017.015 Google Scholar
- Pathogenesis and treatment of impaired wound healing in diabetes mellitus: new insights. Adv Ther. 2014;31(8):817–836. https://doi.org/10.1007/s12325-014-0140-x Crossref, Medline, Google Scholar
- Diabetic foot ulcer: an evidence-based treatment update. Am J Clin Dermatol. 2014;15(3):267–281. https://doi.org/10.1007/s40257-014-0081-9 Crossref, Medline, Google Scholar
- Disturbed hypoxic responses as a pathogenic mechanism of diabetic foot ulcers. Diabetes Metab Res Rev. 2016;32 Suppl 1:179–185. https://doi.org/10.1002/dmrr.2742 Crossref, Medline, Google Scholar
- Challenges in the treatment of chronic wounds. Adv Wound Care. 2015;4(9):560–582. https://doi.org/10.1089/wound.2015.0635 Crossref, Medline, Google Scholar
- Treating the whole not the hole: necessary coupling of technologies for diabetic foot ulcer treatment. Trends Mol Med. 2014;20(3):137–142. https://doi.org/10.1016/j.molmed.2013.12.004 Crossref, Medline, Google Scholar
- Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103(2):137–149. https://doi.org/10.1016/j.diabres.2013.11.002 Crossref, Medline, Google Scholar
- Projection of diabetes population size and associated economic burden through 2030 in Iran: evidence from micro-simulation Markov model and Bayesian meta-analysis. PLoS One. 2015;10(7):e0132505. https://doi.org/10.1371/journal.pone.0132505 Crossref, Medline, Google Scholar
- . Evaluation of negative-pressure wound therapy for patients with diabetic foot ulcers: systematic review and meta-analysis. Ther Clin Risk Manag. 2017;13:533–544. https://doi.org/10.2147/TCRM.S131193 Crossref, Medline, Google Scholar
- Healing of diabetic neuropathic foot ulcers receiving standard treatment. A meta-analysis. Diabetes Care. 1999;22(5):692–695. https://doi.org/10.2337/diacare.22.5.692 Crossref, Medline, Google Scholar
- Vacuum sealing drainage treatment of multi-drug–resistant Enterobacter cloacae wound infection in a diabetic patient: a case report and review of the literature. J Nutr Disorders Ther. 2017;7:1. https://doi.org/10.4172/2161-0509.1000210 Google Scholar
- . Aerobic bacterial profile and antibiotic resistance in patients with diabetic foot infections. Rev Soc Bras Med Trop. 2015;48(5):546–554. https://doi.org/10.1590/0037-8682-0146-2015 Crossref, Medline, Google Scholar
- Conventional treatment versus vacuum therapy for diabetic foot ulcers treatment. Int Surg J. 2017;5(1):49–53. https://doi.org/10.18203/2349-2902.isj20175482 Crossref, Google Scholar
- Burden of diabetic foot ulcers for medicare and private insurers. Diabetes Care. 2014;37(3):651–658. https://doi.org/10.2337/dc13-2176 Crossref, Medline, Google Scholar
- Literature review on the management of diabetic foot ulcer. World J Diabetes. 2015;6(1):37–53. https://doi.org/10.4239/wjd.v6.i1.37 Crossref, Medline, Google Scholar
- Effectiveness and safety of negative-pressure wound therapy for diabetic foot ulcers: a meta-analysis. Plast Reconstr Surg. 2014;134(1):141–151. https://doi.org/10.1097/PRS.0000000000000275 Crossref, Medline, Google Scholar



