![]() ![]() Continuous negative pressure ranging from 80 to 125 mmHg was maintained. Sterile polyurethane foam dressing was designed according to the shape of ulcers and was covered with adhesive drape to create an airtight seal. For NPWT using VAC, a negative pressure system provided by KCI company (San Antonio, TX, USA) was used. The present study was approved by the ethics committee of the Tenth People’s Hospital affiliated to Tongji University.įor both groups of patients, conventional therapy and surgical debridement were applied including glucose control, surgical debridement to remove necrotic tissues and postoperative washing with 1.5% hydrogen peroxide solution, physiological saline ten times diluted Anerdian III skin disinfectant and 0.9% saline, and infection control using appropriate antibiotics if necessary. Informed written consents were obtained from all patients. All patients were divided into two groups according to the treatments they received: the VAC group in which patients received only VAC and the combined group in which patients received both VAC and photon therapy. ![]() Patients with the following characteristics were excluded: 1) patients with other vascular lesions or dermatosis such as active Charcot arthropathy 2) patients with severe diabetic complications such as diabetic nephropathy or diabetic cardiovascular diseases and 3) patients with cancers and other severe systemic diseases such as collagen vascular disease or systemic infection. For all patients, traditional methods such as advanced moist wound therapy dressing were used for > 2 months and were not effective. 22 Areas of foot ulcers for all patients ranged from 5 to 100 cm 2 on calcaneal, dorsal or plantar after debridement. All patients were diagnosed with DFUs with Wagner’s stage 2 or 3. The present retrospective study included a total of 69 patients with DFUs who were admitted to our hospital during the period from January 2014 to December 2015. This study may give more clinical evidence for the application of VAC and photon therapy, as well as improve our understanding of the treatment of DFUs. In the present study, we report the application of VAC combined with photon therapy as the treatment for DFU patients. 21 However, few studies have reported the efficacy of photon therapy in DFUs. 19 Some studies also show that photon therapy is effective in treatment of leg ulcers 20 and cutaneous wounds. 19 It was reported that since the mid-20th century, photon therapy has been used as a standard adjuvant treatment for treating tumors. Photon therapy is reported to be widely used in treatment of cancers. 17 VAC technology uses controlled application of negative pressure to the wound, in which specially designed open-pore foam dressings are cut to the shape of the wound and a vacuum unit gives continuous or intermittent subatmospheric pressure. ![]() NPWT by VAC is a noninvasive system creating a localized controlled negative pressure environment. 16 However, due to the complexity of treatment of DFUs, the medical treatment of DFU remains challenging. Several treatment approaches have been already reported and have certainly improved DFU patients’ conditions, such as advanced moist wound therapy, 12 bioengineered tissue or skin substitutes, 13 growth factors, 14 electric stimulation 15 and negative pressure wound therapy (NPWT) using vacuum-assisted closure (VAC) method. Treatment success for DFUs depends on the mechanisms of action of the therapy, ulcer chronicity and patient compliance. 10 It is estimated that > 85% of foot amputations in patients are caused by DFUs. 8, 9 The treatment of DFUs is considered to be complex, and ulcers can often remain unhealed for months, even years. 7 DFUs are considered to be associated with diabetic neuropathy and peripheral vascular disease and can lead to infection, gangrene and may ultimately lead to amputation. 6Īmong the complications, one of the most common chronic complications is diabetic foot ulcers (DFUs), which are disabling and affect about 15% of people with diabetes. 3– 5 Studies show that compared with the cost of treating diabetes, more costs are spent on treating diabetic complications. 1, 2 Diabetes mellitus can cause a lot of complications, and diabetic patients are more likely to develop complications such as obesity, stroke, coronary heart disease, diabetic retinopathy, diabetic nephropathy and diabetic neuropathy. Diabetes mellitus, one of the most prevalent chronic metabolic diseases, has been estimated to affect over 200 million adults worldwide and the incidence is still rising. ![]()
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