Combination of negative pressure wound therapy using vacuum-assisted closure and ozone water flushing for treatment of diabetic foot ulcers

Objective To investigate the efficacy of negative pressure wound therapy (NPWT) using vacuum-assisted closure (VAC) and ozone water flushing for the treatment of diabetic foot ulcers. Methods The present study included 136 consecutive diabetic foot ulcers (DFUs) patients who went to our hospital during April 2016 to August 2017. The patients were randomly divided into two groups: the combined group in which patients received both VAC and ozone water flushing, and the VAC group in which patients received only VAC. Clinical outcomes were recorded and the change of the wound surface area was calculated. The pain condition was evaluated using the visual analogue scale (VAS) scores. Results The duration of the treatment was significantly shorter and the dressing change times and peak VAS scores were both dramatically lower in the combined group than the VAC group. The reduction of the wound surface area was significantly larger after 1-week, 2-week, and 3-week treatment in the combined group; however, no significant difference was found after 1-month treatment. The bacterial clearance rate was significantly higher after 2-week treatment in the combined group compared with the VAC group; however, no significant difference was found after the whole treatment. No significant difference was observed in the recurrence and amputation rates. Conclusion The combination use could enhance the recovery of DFUs, shorten the treatment duration, and reduce the pain during treatment.