title: Comparative effectiveness of mechanically and electrically powered negative pressure wound therapy devices: a multicenter randomized controlled trial.
abstract: This study was designed to compare the ultraportable mechanically powered Smart Negative Pressure (SNaP) Wound Care System (Spiracur, Sunnyvale, CA) with the electrically powered Vacuum-Assisted Closure (VAC) Therapy System (Kinetic Concepts, Inc. [KCI], San Antonio, TX) in a multicenter, comparative efficacy, noninferiority-powered, randomized controlled trial. We enrolled 132 people with noninfected, nonischemic, nonplantar lower extremity diabetic and venous wounds. Each subject was randomly assigned (1:1) to treatment with either system in conjunction with appropriate off-loading and compression therapy. The trial evaluated treatment for up to 16 weeks or complete wound closure (defined as complete reepithelialization without drainage). Primary end point analysis of wound size reduction found that SNaP-treated subjects demonstrated noninferiority to the VAC-treated subjects at 4, 8, 12, and 16 weeks (p = 0.0030, 0.0130, 0.0051, and 0.0044, respectively). Kaplan-Meier analysis showed no significant difference in complete wound closure between SNaP- and VAC-treated subjects at all time points. Device related adverse events and complications such as infection were also similar between treatment groups. These data support similar wound healing outcomes between the SNaP system and the VAC system in the population studied.
authors.affiliation: Southern Arizona Limb Salvage Alliance, University of Arizona College of Medicine, Tuscon, 1501 N.Campbell Avenue, Tucson, AZ 85724, USA. armstrong@usa.net
authors.forename: David G
authors.initials: DG
authors.lastname: Armstrong
authors.forename: William A
authors.initials: WA
authors.lastname: Marston
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Reyzelman
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kirsner
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D057186:Comparative Effectiveness Research; D017719:Diabetic Foot / Q000628:therapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D054843:Negative-Pressure Wound Therapy / Q000295:instrumentation* / Q000379:methods; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome; D014481:United States; D014647:Varicose Ulcer / Q000628:therapy*; D014945:Wound Healing