الفهرس 
DIABETIC FOOTOnly 14 pages are availabe for public view
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Abstract
T
he study involved 40 patients who had chronic diabetic foot ulcer and were treated at the section of Vascular and General surgery, Ain Shams University Hospitals and Luxor International Hospital, Cairo, Egypt. Starting from December 2021 to May 2022. During the study period, any patient who fulfilled the inclusion criteria was subjected to computer based group A patients were planned for VAC dressing (n =20) while group B patients were planned for treatment with platelets rich plasma (n=20). Ulcer examination was done in all these patients and wound was assessed of its characteristics and photographed. Ulcer was assessed by the investigator at the beginning of the study and at every dressing and photographed for follow up. Size of the wound was assessed by placing a meter scale from the edges of the wound in their longest dimensions.
The mean age of our participants was (58.52 ± 10.7 years and 57.73 ± 10.98 years) for VAC group and PRP group respectively with no statistically significant difference between both groups, we found male predominance as (88%) in VAC group and (75%) in PRP group were males with statistically insignificant difference between both groups.
According to the duration represents in weeks non healing ulcers; duration of 12-15 weeks were 5 patients; followed by the maximum patients duration of 16 - 19 weeks were 19 patients; duration of 20 - 23 weeks were 11 patients; however; duration of 24-26 weeks were 5 patients.
In our study, 16(40%) out of 40 patients developed chronic non healing ulcer following trauma and 24 (60%) patients had venous ulcer followed by trophic and vasulitic etiology.
In our study most common location of chronic non healing ulcer is lower limb 35 (87.5 %) out of 40 patients next being torso 3 (7.5 %) patients and only 2 (5 %) patients on upper limb.
Majority of the patients in both control and cases had serous or serosanguinous discharge. (Patients with infection or purulent discharge were not included in study).
In our study of 40 patients the ulcer size ranged from 6 to 15 cm2. The mean size in group (A) was 9.48±1.91 cm2 and among group (B) 9.56 ±1.87 cm2.
In our study we observed that healing in cases or experimental group took significantly less time when compared with group (A). The mean duration of healing in control group was 7.3 ±1.91 weeks and mean duration of healing for group (B) was 4.38±1.94 weeks. The probability value (p value) obtained after applying unpaired t test for the above data comes out to be 0.0001 which is statistically significant.
In our study we observed that healing in cases or experimental group took significantly lesser number of dressings when compared with control group. The mean number of dressings required for healing in group (A) was 12.8 ±1.94, and number of dressings required for healing in group (B) was 7.60 ±2.9. The probability value (p value) obtained after applying unpaired t test for the above data comes out to be 0.0001 which is statistically significant. In the present study, an attempt has been made to establish better healing rates with use of PRP and VAC in diabetic foot ulcers.
CONCLUSION AND RECOMMENDATION
Conclusion
In conclusion, the results from our case series showed that PRP and VAC are a safe and effective treatment modality for chronic non-healing ulcers. Using PRP to treat chronic wounds/ ulcers may not only enhance healing, but also prevent lower extremity amputations caused by non-healing wounds. Therefore, further research and randomized controlled clinical trials on larger patient population are necessary to validate the results.
VAC therapy is newer and a safe method of treatment for Diabetic Foot Ulcers. There is faster wound healing, good graft and flap take and lesser duration of hospital stay with minimal or no complications. So it is efficacious in the treatment for diabetic foot ulcers.
Recommendation
Regarding study design we recommended conducting:
• Randomized prospective clinical trials on larger patient population in multicenter are necessary to validate the results.
• Other comparing studies between PRP and VAC as there were a little available paper comparing them with further outcomes as effect on pain
Regarding treatment modalities we recommended to:
• Development of a standard protocol for the preparation of PRP, as literature currently there is no standardization of the procedure.
• Development of a treatment protocol for using PRP or VAC as doses and co-dressing used in different ulcers type especially DFU.