Case reports Managing diabetic foot ulceration with a new, highly portable NPWT device
Figure 5 and 6 (above left and right). NPWT with SNaP continued.
Figure 7 and 8 (above left and right). Mr M’s wound continues to heal with Figure 8 showing full healing.
options. The dressing, cartridge and interface materials are changed twice-weekly. The system’s ease of use, portability and
non-interference with patients’ lifestyles makes it an ideal product for managing the diabetic foot ulceration, particularly in the community environment.
CASE STUDY Background Mr M is a middle-aged, self-employed surveyor who lives and works in London. Due to his work and social circumstances, Mr M prefers to opt for private healthcare provision. He has a private general practitioner and if required receives hospital care in a large private hospital in central London. His work means that he spends considerable time on building sites, liaising with workmen and directing construction work. Mr M developed type 2 diabetes mellitus some
10 years ago. While he generally manages his blood sugars well, long working days and the unpredictability of his daily routine can pose challenges and long periods of standing, linked
with the need to use rigid safety boots, has caused Mr M a number of foot-related issues in the past. This resulted in the development, on two separate occasions, of a diabetic foot ulcer on the lateral border of his left foot. At each occurrence, clinical investigations
identified good vascularity, but highlighted a significant degree of neuropathy. Each episode of ulceration also resulted in underlying osteomyelitis. Previous treatments for diabetic foot ulceration
required the surgical exploration of the wound, removal of infected bone and non-viable tissue, and the use of systemic antibiotics, often over prolonged time periods. At each surgical episode the wound was left to drain and heal by secondary intention. To manage exudate and control wound bioburden, as well as stimulating angiogenesis and wound granulation, NPWT was initiated.
Current problem Mr M was admitted to hospital with further ulceration to the lateral border of his left foot. Mr M was managed by a multidisciplinary team, which
References
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10. Leaper D. Evidence-based wound care in the UK. Int Wound J. 2009; 6(2): 89–91.
11. Leaper D. Cochrane: Hands off Wound Care! Int Wound J, 2009; 6(4): 309–10.
12. Wounds UK. Best Practice Statement: Gauze-based Negative Pressure Wound Therapy, 2008; Wounds UK, Aberdeen.
13. Fong KD, Hu D, Eichstadt S, et al. “The SNaP system: biomechanical and animal model testing of a novel ultraportable negative-pressure wound therapy system.” Plast Reconstr Surg, 2010; 125(5): 1362–71.
14. Armstrong DG, Marston WA, Reyzelmen A, Kirsner RS. Comparative effectiveness of mechanically and electrically powered negative pressure wound therapy devices: A multicenter randomized controlled trial. Wound Rep Reg, 2012; 20 (3): 332-41.
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Technology and product reviews CASE REPORTS
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