Gauze Suction Dressing, A Cost Effective Alternative to Standard Vaccum Assisted Closure Device for Treatment of Diabetic Foot Ulcers - A Prospective Cohort Study

Abstract

Abstract: Hospital suction assisted VAC dressing, also known as vacuum assisted closure (VAC), is a therapeutic technique using a suction pump, tubing and a dressing to remove excess exudate and promote healing in acute or chronic wounds. This involves the controlled application of sub-atmospheric pressure to the local wound environment, using a sealed wound dressing connected to a suction unit in the beside of hospital.
Materials and Methods: A prospective, Observational cohort study was designed and approved by the Institutional Review Board. 81 patients (N = 45 in the GSUC arm and N = 36 in the VAC arm) were observed under this study, undertaken between September 2020 and May 2021.The study comprised patients with DM foot ulcers of maximum size 15cm. All patients who were eligible were offered the opportunity to participate in the study. Wound was assessed every 5 days, with a maximum of 3 dressings were done. The progress was recorded systematically and photographed after each dressing to assess the shrinkage in size. Time taken to apply dressing, pain levels, failure of treatment and the overall cost incurred during the treatment was noted and analysed. Results: Low income countries are having number of issues in public health. The use of Hospital suction unit assisted VAC in the Indian studies has not been reported much. Only few Indian studies have provided ideas into the hospital suction unit assisted VAC dressing use in Indian settings. The hospital suction unit assisted VAC dressing is definitely having an advantage in countries like India, where the patient load on the health centers is high. In countries like India, where more % of the population earns less than one US dollar per day and where only a small portion of government budget goes to health there is an urgent need of faster and cheaper wound healing techniques.Conclusion: The VAC will also reduce the total time spent in the hospital and this is ideal for already overloaded hospitals and reduced the daily dressing pain suffering of the patient and it is much cheaper than the negative pressure wound therapy (NPWT) dressing. Besides, the number of follow-ups will also be reduced in cases involving the VAC. But the situation in the rural areas is graver. As, the VAC is not available everywhere in the developing countries and the usage of VAC in the rural areas is very difficult due to difficulties related to terrain, availability of devices, cost issues, etc. Thus the use of such cost effective suction unit for wound management which can be used in rural areas of developing countries is essential.