title: A Multicenter Randomized Controlled Trial Comparing Treatment of Venous Leg Ulcers Using Mechanically Versus Electrically Powered Negative Pressure Wound Therapy.
abstract: Objective:This study compares two different negative pressure wound therapy (NPWT) modalities in the treatment of venous leg ulcers (VLUs), the ultraportable mechanically powered (MP) Smart Negative Pressure (SNaP®) Wound Care System to the electrically powered (EP) Vacuum-Assisted Closure (V.A.C.®) System.Approach:Patients with VLUs from 13 centers participated in this prospective randomized controlled trial. Each subject was randomly assigned to treatment with either MP NPWT or EP NPWT and evaluated for 16 weeks or complete wound closure.Results:Forty patients (n=19 MP NPWT andn=21 EP NPWT) completed the study. Primary endpoint analysis of wound size reduction found wounds in the MP NPWT group had significantly greater wound size reduction than those in the EP NPWT group at 4, 8, 12, and 16 weeks (p-value=0.0039, 0.0086, 0.0002, and 0.0005, respectively). Kaplan-Meier analyses showed greater acceleration in complete wound closure in the MP NPWT group. At 30 days, 50% wound closure was achieved in 52.6% (10/19) of patients treated with MP NPWT and 23.8% (5/21) of patients treated with EP NPWT. At 90 days, complete wound closure was achieved in 57.9% (11/19) of patients treated with MP NPWT and 38.15% (8/21) of patients treated with EP NPWT.Innovation:These data support the use of MP-NPWT for the treatment of VLUs.Conclusions:In this group of venous ulcers, wounds treated with MP NPWT demonstrated greater improvement and a higher likelihood of complete wound closure than those treated with EP NPWT.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University of North Carolina School of Medicine , Chapel Hill, North Carolina.
authors.forename: William A
authors.initials: WA
authors.lastname: Marston
authors.affiliation: Southern Arizona Limb Salvage Alliance (SALSA), University of Arizona College of Medicine , Tucson, Arizona.
authors.forename: David G
authors.initials: DG
authors.lastname: Armstrong
authors.affiliation: Department of Medicine, California School of Podiatric Medicine at Samuel Merritt University , Oakland, California.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Reyzelman
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine , Miami, Florida.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kirsner