Abstract

Objectives: Diabetic foot ulcerscause infections and tissue loss as a result of a vicious circle including peripheral neuropathy, vascular insufficiency, and immune disorders. This destructive period restrict the reconstruction options and highlights skin graft repair option. The success of the graft depends on the adequate granulation tissue without infection. Vacuum assisted closure system therapy is very successful and effective for providing of this dual effect. In this study, we analyzed the effectiveness of the VAC applications combined with debridement in 20 cases with diabetic foot ulcer retrospectively.

Materials and Methods: VAC treatment was applied for 7 sessions meanly for 36 h under 125-150 mm Hg intermittently and waiting period for 12h combining with recurrent debridement. Decreasing in the wound dimensions by contractions and evident increasing the granulation tissue in the wounds were observed just from the second session of the VAC therapy.

Results: After the sufficient thickness granulation tissue formation, the wounds were repaired by split thickness skin grafts. No recurrence was seen except of two patients with heel ulcers. Distal transmetatarsal reamputation was performed to 3 patients after 6 months.

Conclusion: VAC treatment is very safe and effective in wound healing including the improvement of granulation tissue, drainage of infection, and wound contraction. The determining factor on the effectiveness of VAC treatment is debridement which is performing effectively on time.

Key Words: Diabetic Foot; Vacuum-Assisted Closure; Debridement.