Clinical experience of a new NPWT system in diabetic foot ulcers and post-amputation wounds.
OBJECTIVE
The primary aim of this pilot observational study was to assess the reduction in wound depth and area achieved with a new negative pressure wound therapy (NPWT) system in diabetic patients with foot ulcers and post-amputation wounds. Secondary aims were to assess pain levels, extent of exudate removal, and ease of use of the system for both the patient and care giver.


METHODS
Patients in both acute and home care settings were enrolled into this 4-week study. Dressings were changed three times per week. Wound area and depth, exudate removal and pain severity were evaluated at each dressing change. At the final visit, the investigators and patients were surveyed with respect to equipment and dressings used in the study.


RESULTS
Sixteen patients were enrolled into the study. Data relating to 14 patients with a variety of post-amputation wounds were included in the intention-to-treat (ITT) analysis. The post-amputation wounds showed a general trend for a reduction in the median wound surface area between baseline (22.9cm2; range 0.5-55) and the final visit (15.3cm2; range 2.4-63.5). This equates to a median change (calculated from the percentage change in wound area for each patient individually) of -41% (range -82% to +15%). There was also a general trend in reduction in the median depth between baseline (17mm; range 0-35) to final visit (5mm; range 0-35). One patient presented with a foot ulcer that demonstrated a 50% reduction in depth from baseline to the final assessment. The device effectively managed wound exudate and most patients reported low pain levels during therapy. Ease of use of the system was rated very highly by investigators and patients.


CONCLUSIONS
This pilot study indicates that the use of the new NPWT system can be expected to have a positive effect on the healing of post-amputation wounds and foot ulcers in patients with diabetes. The findings demonstrate that the system is easy to use, effectively controls exudate and minimises pain and inconvenience for patients being treated with NPWT.


BACKGROUND
This study was sponsored by Mölnlycke Heath Care (Gothenburg, Sweden) and Medela AG (Baar, Switzerland). The authors have no other conflicts of interest that are directly relevant to the content of this manuscript.
Freeman Hospital, Newcastle upon Tyne, UK. Gerard.stansby@nuth.nhs.uk
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G
Stansby
V
V
Wealleans
L
L
Wilson
D
D
Morrow
C
C
Gooday
K
K
Dhatariya
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000534:rehabilitation*; D000672:Amputation Stumps / Q000473:pathology; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D017719:Diabetic Foot / Q000175:diagnosis / Q000628:therapy*; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000523:psychology; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D012449:Safety; D017592:Skin Care / Q000379:methods; D016896:Treatment Outcome; D006113:United Kingdom; D014945:Wound Healing