COMPARATIVE EFFICACY OF VACUUMASSISTED CLOSURE VERSUS PLATELETDERIVED GROWTH FACTOR DRESSING IN THE MANAGEMENT OF DIABETIC FOOT ULCERS: A PROSPECTIVE RANDOMIZED STUDY

Abstract

Background: Diabetic foot ulcers (DFUs) are among the most challenging complications of diabetes mellitus, often leading to prolonged morbidity, infection, and amputations. Advanced wound care modalities such as vacuum-assisted closure (VAC) therapy and platelet-derived growth factor (PDGF) dressing have been introduced to enhance healing, but comparative evidence remains limited.

Objectives: To evaluate and compare the efficacy of VAC dressing and PDGF dressing in terms of wound healing outcomes in patients with DFUs.

Methods: This prospective randomized comparative study was conducted at Saveetha Medical College and Hospital between March 2023 and March 2024. A total of 40 patients with chronic DFUs (>4 weeks) unresponsive to conventional therapy were enrolled and randomized into two groups: VAC dressing (n=20) and PDGF dressing (n=20). Inclusion criteria were patients aged 30–60 years with type 2 diabetes and persistent DFUs. Exclusion criteria included systemic disorders, advanced peripheral vascular disease, coagulopathies, and poor compliance. The primary outcome was the percentage reduction in ulcer size at 4 and 8 weeks. Secondary outcomes included time to complete healing, granulation tissue formation, infection control, and complication rates.

Results: VAC therapy demonstrated a significantly greater mean reduction in ulcer size at 4 weeks (62.4% ± 8.1) compared to PDGF dressing (48.2% ± 7.9, p<0.05). At 8 weeks, complete healing was achieved in 14/20 patients (70%) in the VAC group versus 9/20 (45%) in the PDGF group. VAC therapy also showed faster granulation tissue development and fewer wound infections.

Conclusion: VAC dressing was superior to PDGF dressing in accelerating wound healing and achieving higher rates of complete closure in DFUs. Its simplicity, effectiveness, and lower infection rate suggest that VAC should be preferred as a primary advanced wound care strategy in diabetic foot management.