Comparative Efficacy of Negative Pressure Wound Therapy Combined with Artificial Skin Substitutes or Autogenous Skin Grafts in the Treatment of Diabetic Foot Ulcers

Abstract

Background: Diabetic foot ulcers (DFUs) are a common and debilitating complication of diabetes mellitus, often leading to prolonged healing times, high recurrence rates, and an increased risk of infection, potentially requiring amputation. Negative Pressure Wound Therapy (NPWT) has shown effectiveness in DFU treatment, but the combination of NPWT with either artificial skin substitutes or autogenous skin grafts remains a subject of ongoing investigation.

Objective: To evaluate and compare the efficacy of NPWT combined with artificial skin substitutes and NPWT combined with autogenous skin grafts in promoting wound healing in patients with chronic, non-healing DFUs.

Methods: This prospective, comparative study was conducted at Venkateshwara Medical College, enrolling 100 patients with chronic DFUs. The patients were randomly assigned to two groups: Group A (NPWT + Artificial Skin Substitute) and Group B (NPWT + Autogenous Skin Graft). Wound healing progress was monitored over 12 weeks, assessing wound closure, time to complete closure, infection rates, and the need for further interventions. Statistical analysis was conducted using SPSS, with a significance level of p < 0.05.

Results: At the end of 12 weeks, Group B (NPWT + Autogenous Skin Graft) demonstrated superior outcomes with 90% wound closure compared to 85% in Group A (NPWT + Artificial Skin Substitute). Group B also achieved complete wound closure significantly faster (48 days vs. 56 days, p < 0.05). Both groups had low infection rates, but Group B required fewer additional interventions (4% vs. 8%, p = 0.04). Granulation tissue formation was faster and more consistent in Group B, contributing to quicker healing.

Conclusion: NPWT combined with autogenous skin grafts offers superior healing outcomes for diabetic foot ulcers, with faster wound closure, fewer complications, and a reduced need for additional interventions compared to NPWT combined with artificial skin substitutes. Autogenous skin grafting remains the gold standard for DFU treatment, especially for more severe wounds.