Abstract

Abstract :
 Background : Diabetic foot wounds affecting either limb is seen in immense numbers on out patient basis in the department of general surgery all over India. They present to the health care professionals in varying general conditions , ranging from a simple wound with adequate granulation tissue which can be managed on OPD basis to   v those presenting in septic shock and MODS due to poorly managed wound and systemic control of diabetes mellitus , hence requiring admission. Innovations are being tried with respect to the type of dressings to hasten the formation of granulation tissue, decrease the size of the wound and reduce the foul smelling exudate in diabetic foot wounds. On similar grounds a novel dressing technique using a combination of NPWT and topical insulin has been tried on diabetic foot wounds and its results assessed using accepted criterias.
objectives : To assess the reduction in the size of the wound when a combination of NPWT and topical insulin is used using the BATES - JENSEN WOUND ASSESSMENT TOOL as compared to plain NPWT on diabetic foot ulcers in Type 2 diabetic patients.
methodology: The present prospective interventional study was done by the Department of Surgery at JSS Medical College and Hospital , Mysuru from July 2019 to  December 2021. A total of 96 study patients were enrolled for the study out of which 48 subjects were divided randomly into two group namely case and control group. Evidence of granulation tissue formation, decrease in the size and depth of the wound ,decrease in the amount of exudate, peripheral tissue induration as well as an increase in epithelisation of the wound is assessed by the BATES - JENSEN WOUND ASSESEMENT TOOL  on the 5th, 10th and 15th day, using the BATES- JENSEN WOUND ASSESSMENT SCALE. RESULTS : Using the Bates Jensen Wound Assessment tool this study showed that the BWAT score which was 43.39 on day 5 in the VAC group reduced to 32.5 on day 15 in the same group whereas the BWAT score which was 41.7 on day 5 in VAC + topical insulin group reduced to 27.1 on day 15 , which was found to be statistically significant. CONCLUSION :This study has shown that on using NPWT + topical insulin as a dressing method for diabetic foot wounds as compared to NPWT alone there has been significant reduction in the size of the wound , hastening in the process of formation of granulation tissue hence proving that a combination of NPWT + topical insulin is an effective dressing method for diabetic foot wounds .