• Adjuvant therapy
• Diabetic foot ulcers
• Guidelines
• Healing
• Meta-analysis

• Case report
• Diabetic foot
• Polydeoxyribonucleotides
• Regenerative medicine
• Wound healing

• diabetic foot ulcers
• low-cost
• negative pressure wound therapy
• wound
• wound care
• wound dressing
• wound healing

• Humans
• Negative-Pressure Wound Therapy/methods
• Diabetic Foot/therapy
• Retrospective Studies
• Wound Healing
• Bandages
• Diabetes Mellitus

• Humans
• Conservative Treatment
• Negative-Pressure Wound Therapy
• Finger Injuries/surgery
• Amputation, Traumatic/surgery
• Metaplasia
• Amputation, Surgical

• Animals
• Rats
• Arginase
• Chemokine CCL2
• Diabetes Mellitus, Experimental/complications
• Diabetes Mellitus, Experimental/therapy
• Inflammation
• Interleukin-6
• Negative-Pressure Wound Therapy
• Vascular Endothelial Growth Factor A

Diabetic foot ulcers not only have a negative impact on patient mortality, morbidity and quality of life, but also require high resource utilization to achieve complete wound healing. The aim of this evaluation was to compare resource utilization of negative pressure wound therapy (NPWT) and standard moist wound care (SMWC) for diabetic foot wounds after amputation, surgical debridement or wound cleansing.

The multicenter clinical DiaFu study enrolled 368 adults with diabetic foot ulcers between December 23, 2011 and October 21, 2014. Patients were randomly assigned to NPWT and SMWC. Evaluation of direct resource use comprised inpatient and outpatient treatment time, and personnel and material for wound treatment within 16 weeks. This resource use analysis was primarily based on the per protocol population (NPWT 44; SMWC 110).

Treatment duration was 16 days shorter with NPWT (mean (SD) 82.8 (31.6), SMWC 98.8 (24.6); U test, p = 0.001) with 14.9 days shorter outpatient treatment (mean (SD) NPWT 68.3 (31.1), SMWC 83.2 (29.7)). The number of dressing changes per study participant was lower with NPWT (mean (SD) 35.1 (18.6), SMWC (42.9 (21.4); U test, p = 0.067). Time per dressing change was significantly lower with SMWC (mean (SD) 19.7 (12.8), NPWT (16.5 (8.2) minutes; U test, p < < 0.0001). Time for surgical debridements per study participant was 23.3 minutes shorter with NPWT (mean (SD) 20.5 (20.5), SMWC (43.8 (46.7); U test, p = 0.395).

Resource use was lower for NPWT, which may be an efficient treatment alternative to SMWC for diabetic foot wounds, to be demonstrated in subsequent cost analyses.

clinicaltrials.govNCT01480362 on November 28, 2011

The online version contains supplementary material available at 10.1186/s13047-022-00569-w.

• Diabetic foot
• Negative pressure wound therapy
• Resource use
• Wound
• Wound care

• advanced treatments
• diabetic foot ulcers
• standard of care
• wound healing

• Diabetes Mellitus
• Diabetic Foot/therapy
• Fibroblasts
• Humans
• Negative-Pressure Wound Therapy
• Peripheral Arterial Disease
• Wound Healing

• diabetes
• diabetic ulcer
• diabetic wound
• murine
• therapeutic
• wound healing

• Animals
• Diabetes Mellitus, Experimental
• Disease Models, Animal
• Humans
• Mice
• Research Design
• Wound Healing

• R01 GM050875 NIGMS NIH HHS
• R35 GM139603 NIGMS NIH HHS
• R01 AR069541 NIAMS NIH HHS

Because China is becoming an aging society, the incidence of diabetes and diabetic foot have been increasing. Diabetic foot has become one of the main health-related killers due to its high disability and mortality rates. Negative pressure wound therapy (NPWT) is one of the most effective techniques for the treatment of diabetic foot wounds and great progress, both in terms of research and its clinical application, has been made in the last 20 years of its development. However, due to the complex pathogenesis and management of diabetic foot, irregular application of NPWT often leads to complications, such as infection, bleeding and necrosis, that seriously affect its treatment outcomes. In 2020, under the leadership of Burns, Trauma and Tissue Repair Committee of the Cross-Straits Medicine Exchange Association, the writing group for ‘Consensus on the application of negative pressure wound therapy of diabetic foot wounds’ was established with the participation of scholars from the specialized areas of burns, endocrinology, vascular surgery, orthopedics and wound repair. Drawing on evidence-based practice suggested by the latest clinical research, this consensus proposes the best clinical practice guidelines for the application and prognostic evaluation of NPWT for diabetic foot. The consensus aims to support the formation of standardized treatment schemes that clinicians can refer to when treating cases of diabetic foot.

• Diabetic foot
• Diabetic ulcer
• Diabetic wound
• Negative pressure wound therapy
• Suction wound closure therapy
• Topical negative pressure therapy
• Vacuum sealing drainage
• Vacuum-assisted closure
• Vacuum-assisted therapy

Negative pressure wound therapy (NPWT) with instillation therapy (V.A.C. Vera-Flow™) and dwell time (NPWTi-d) is an innovative method for complex wound healing. NPWTi-d combines vacuum-aided drainage of wounds with the precise distribution of topical cleansing solution over the wounds. Furthermore, super oxidized solutions have illustrated their ability to potentiate wound healing and decrease bacterial contamination. Furthermore, aided with this method, infected wounds can be disinfected. If surgical debridement or removal of the infected site is not possible or desired. Therefore, in the case of a 66-year-old patient with diabetic foot syndrome (DFS) with severe infection, our approach was to couple NPWTi-d with instillation and dwelling of super oxidized solution to bolster benefits. This is the first case report using NPWTi-d with instillation of super oxidized solution in DFS in Switzerland. This case indicates that this approach is beneficial in the treatment of complex and critically infected wounds in DFS.

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Infections in isolated liposuction procedures are reported as only 0.1 % of cases

Liposculpture procedures have a complication rate of 5%, with the majority being minor complications. Infections in isolated liposuction procedures are as low as 0.1 % of cases. Necrotizing infections can occur after major traumatic injuries, as well as after minor breaches of the skin or mucosa. Here we present a case of a 53-year-old female patient who underwent cosmetic surgery and developed a necrotizing soft tissue infection and we will discuss the importance of early diagnosis, risk factors and preventive measures, treatment options and our management of this particular case.

53-year-old female patient with a history of multiple cosmetic surgeries, with no significant past medical history, she presented fever and disabling pain at the surgical site with extensive bullae formation; during her fourth post operative day, she presented septic shock that required vasopressor support and mechanical ventilation, accompanied by acute renal failure which required admission to the intensive care unit.

The patient’s relatives requested air transportation to bring the patient to our center.

The patient remained hospitalized for 42 days in which 15 surgical interventions were performed including multiple surgical wound cleansing and debridement as well as placement of a negative pressure wound therapy system, flaps advancement, lesions reconstruction, graft procurements and insertions.

Antibiotic prophylaxis is recommended preferably with a second-generation cephalosporin, one hour prior to surgery and should be continued for 5–6 days afterwards. Likewise, prophylaxis with Flucloxacillin or gentamicin is recommended in the case of liposuction and or abdominoplasty. The microorganisms most frequently isolated in post-liposuction infections are Staphylococcus aureus, Streptococcus group A, Streptococcous pyogenes, and synergistic infections with anaerobes and facultative pathogens.

Among the most severe complications of liposuction is necrotizing soft tissue infection (NSTI), which is an infection of the subcutaneous tissue that spreads to the underlying dermis and sometimes beyond including the fascia and muscle.

Rapid recognition of NSTI is life-saving and urgent, extensive debridement and prophylactic antibiotics are the mainstay treatment for this condition, multiple debridement procedures may be necessary for successful treatment.