Negative-pressure wound therapy for management of diabetic foot wounds: a review of the mechanism of action, clinical applications, and recent developments

Muhammed Y Hasan, Rachel Teo, Aziz Nather, Muhammed Y Hasan, Rachel Teo, Aziz Nather

Abstract

Negative-pressure wound therapy (NPWT) plays an important role in the treatment of complex wounds. Its effect on limb salvage in the management of the diabetic foot is well described in the literature. However, a successful outcome in this subgroup of diabetic patients requires a multidisciplinary approach with careful patient selection, appropriate surgical debridement, targeted antibiotic therapy, and optimization of healing markers. Evolving NPWT technology including instillation therapy, nanocrystalline adjuncts, and portable systems can further improve results if used with correct indications. This review article summarizes current knowledge about the role of NPWT in the management of the diabetic foot and its mode of action, clinical applications, and recent developments.

Keywords: amputation; diabetic ulcers; subatmospheric pressure dressing; topical negative-pressure therapy; vacuum therapy; wound bed preparation.

Figures

Fig. 1
Fig. 1
Schematic illustrating NPWT's mechanism of action.
Fig. 2
Fig. 2
Application of NPWT dressing.
Fig. 3
Fig. 3
(a) Wound after surgical debridement. (b) Wound after 2 weeks of NPWT. (c) Healed wound at 6 weeks post-surgery.

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