title: A comparison of diabetic foot ulcer outcomes using negative pressure wound therapy versus historical standard of care.
abstract: Diabetic foot ulcers (DFUs) are a leading cause of morbidity and hospitalisation among patients with diabetes. We analysed claims data for Medicare part B diabetic foot ulcer patients treated with Negative Pressure Wound Therapy at home (N = 1135) and diabetic foot ulcer patients from a published meta-analysis of randomised controlled wet-to-moist therapy. The expected costs of care for the two treatments were also compared. A significantly greater proportion of wounds treated with NPWT achieved a successful treatment endpoint compared with wet-to-moist therapy at both 12 weeks (39.5% versus 23.9%; P < 0.001) and 20 weeks (46.3% versus 32.8%; P < 0.001). NPWT-treated patients reached a successful wound treatment endpoint more rapidly, and the benefit was apparent in all wound sizes. Expected 20-week treatment costs for NPWT were similar to those for wet-to-moist therapy if one nursing visit per day for the latter is assumed but 42% less if two nursing visits per day are made. Thus, NPWT may improve the proportion of DFUs that attain a successful wound treatment endpoint and decrease resource utilisation by a given health care system compared with standard wet-to-moist therapy.
authors.affiliation: Texas A&M Health Science Center College of Medicine, Department of Surgery, Scott and White Hospital, Temple, TX 78628, USA. llavery@swmail.sw.org
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Lavery
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Boulton
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Niezgoda
authors.forename: Peter
authors.initials: P
authors.lastname: Sheehan
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D017719:Diabetic Foot / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000191:economics; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing