Does negative pressure wound therapy with irrigation improve clinical outcomes? A randomized clinical trial in patients with diabetic foot infections

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Lawrence A Lavery 1, Kathryn E Davis 2, Javier La Fontaine 2, J David Farrar 3, Kavita Bhavan 4, Orhan K Oz 5, Peter A Crisologo

Main idea: The addition of irrigation to Negative Pressure Wound Therapy did not change clinical outcomes in patients with diabetic foot infections.

Abstract

Aim: To compare the efficacy of Negative Pressure Wound Therapy (NPWT) with and without irrigation with 0.1% polyhexanide-betaine.

Methods: We randomized 150 subjects in a 16-week RCT to compare healing in patients with diabetic foot infections. NPWT delivered at 125 mm Hg continuous pressure. NPWT-I were administered at 30 cc per hour. Results: There were no differences clinical treatment or outcomes: wound area after surgery (18.5%) and duration of antibiotics (39.7%) Time to healing (56.3%) and length of stay (13.8%) were all the same. Re-infection and re-hospitalization were slightly more likely to occur after surgery than after hospitalization. There were also differences in the number of surgeries and the length of stays.

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