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      Efficacy of negative pressure wound therapy using vacuum-assisted closure combined with photon therapy for management of diabetic foot ulcers

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          Abstract

          Background

          Diabetes mellitus, one of the most prevalent chronic metabolic diseases, causes many complications. Among the complications, one of the most common chronic complications is diabetic foot ulcers (DFUs).

          Objective

          This study was conducted to investigate the efficacy of negative pressure wound therapy using vacuum-assisted closure (VAC) combined with photon therapy for the management of DFUs.

          Patients and methods

          The study included a total of 69 patients with DFUs during the period from January 2014 to December 2015. All patients were diagnosed with DFUs with Wagner’s stage 2 or 3 and were divided into two groups – the VAC group in which patients received only VAC and the combined group in which patients received both VAC and photon therapy. Data on duration of the treatment, pre- and postoperative wound surface areas, dressing changing times, pain conditions assessed using visual analog scale scores, recurrence rate and amputation rate were collected.

          Results

          Among all patients, 35 patients were divided into the VAC group and 34 patients into the combined group. Areas of foot ulcers for all patients ranged from 5 to 100 cm 2. The treatment duration, dressing changing times and the peak value of visual analog scale scores were all significantly lower in the combined group compared with the VAC group ( P < 0.05). However, the reduced area for wound surface showed no significant difference between the two groups. Both recurrence and amputation rates showed no significant difference between the two groups of patients.

          Conclusion

          Both VAC and VAC combined with photon therapy were effective and safe in the treatment of DFUs, while the combined therapy might have accelerated wound healing, but did not influence the long-term efficacy.

          Most cited references23

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          Recent advances on the development of wound dressings for diabetic foot ulcer treatment--a review.

          Diabetic foot ulcers (DFUs) are a chronic, non-healing complication of diabetes that lead to high hospital costs and, in extreme cases, to amputation. Diabetic neuropathy, peripheral vascular disease, abnormal cellular and cytokine/chemokine activity are among the main factors that hinder diabetic wound repair. DFUs represent a current and important challenge in the development of novel and efficient wound dressings. In general, an ideal wound dressing should provide a moist wound environment, offer protection from secondary infections, remove wound exudate and promote tissue regeneration. However, no existing dressing fulfills all the requirements associated with DFU treatment and the choice of the correct dressing depends on the wound type and stage, injury extension, patient condition and the tissues involved. Currently, there are different types of commercially available wound dressings that can be used for DFU treatment which differ on their application modes, materials, shape and on the methods employed for production. Dressing materials can include natural, modified and synthetic polymers, as well as their mixtures or combinations, processed in the form of films, foams, hydrocolloids and hydrogels. Moreover, wound dressings may be employed as medicated systems, through the delivery of healing enhancers and therapeutic substances (drugs, growth factors, peptides, stem cells and/or other bioactive substances). This work reviews the state of the art and the most recent advances in the development of wound dressings for DFU treatment. Special emphasis is given to systems employing new polymeric biomaterials, and to the latest and innovative therapeutic strategies and delivery approaches. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
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            Burden of diabetic foot ulcers for medicare and private insurers.

            To estimate the annual, per-patient incremental burden of diabetic foot ulcers (DFUs).
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              • Article: not found

              The management of diabetic foot: A clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine.

              Diabetes mellitus continues to grow in global prevalence and to consume an increasing amount of health care resources. One of the key areas of morbidity associated with diabetes is the diabetic foot. To improve the care of patients with diabetic foot and to provide an evidence-based multidisciplinary management approach, the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine developed this clinical practice guideline.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                1176-6336
                1178-203X
                2018
                25 October 2018
                : 14
                : 2113-2118
                Affiliations
                [1 ]Department of interventional Vascular Surgery, The Tenth People’s Hospital affiliated to Tongji University, Tongji University School of Medicine, shanghai, 200072, China, cjr.limaoquan@ 123456vip.163.com
                [2 ]Department of interventional Catheter, The Tenth People’s Hospital affiliated to Tongji University, Shanghai, 200072, China
                [3 ]Department of Anesthesiology, eastern hospital affiliated to Tongji University, Shanghai, 200120, China
                [4 ]Department of Emergency, The Tenth People’s Hospital affiliated to Tongji University, Shanghai, 200072, China, jiangjinxia99@ 123456163.com
                Author notes
                Correspondence: Jinxia Jiang Department of Emergency, The Tenth People’s Hospital Affiliated to Tongji University, 301 Yanchang Middle Road, Jing’an District, Shanghai 200072, China, Email jiangjinxia99@ 123456163.com
                Maoquan Li, Department of interventional Vascular Surgery, The Tenth People’s Hospital affiliated to Tongji University, Tongji University School of Medicine, 301 Yanchang Middle Road, Jing’an District, shanghai, 200072, China, Email cjr.limaoquan@ 123456vip.163.com
                [*]

                These authors contributed equally to this work

                Article
                tcrm-14-2113
                10.2147/TCRM.S164161
                6207409
                30498354
                83bcba8c-6cb0-4b7c-ab33-2b227353d685
                © 2018 Hu et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Medicine
                diabetic foot ulcer,vacuum-assisted closure,photon therapy
                Medicine
                diabetic foot ulcer, vacuum-assisted closure, photon therapy

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