A Comparative Study to Evaluate the Effect of Negative Pressure Wound Therapy and 3% Hypertonic Saline Dressings in the Management of Diabetic Foot Ulcers

Objective: Diabetic foot ulcers are a major cause of morbidity, prolonged hospitalization, and lower-extremity amputation among patients with diabetes mellitus. Negative pressure wound therapy (NPWT) has emerged as an advanced wound management modality with potential benefits over conventional dressings. The present study was undertaken to compare the effectiveness of NPWT and 3% hypertonic saline dressing in the management of diabetic foot ulcers. Material and methods: This prospective comparative study was conducted in the Department of General Surgery, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Hyderabad, India, between January 2022 and December 2024. A total of 230 patients with Wagner grade 1 and 2 diabetic foot ulcers were included. Following surgical debridement and infection control measures, 115 patients were treated with NPWT, and 115 patients received 3% hypertonic saline dressings. Patients were followed for four weeks. Outcomes assessed included wound healing, duration of hospital stay, requirement for debridement, and amputation rate. Results: Baseline demographic and clinical characteristics were comparable between the two groups. Mean wound dimensions in the NPWT group decreased from 8.59 ± 1.43 cm × 4.32 ± 1.25 cm to 3.20 ± 1.12 cm × 2.52 ± 1.32 cm, whereas in the hypertonic saline group they decreased from 7.98 ± 1.34 cm × 4.80 ± 1.85 cm to 5.25 ± 1.48 cm × 2.78 ± 1.89 cm (p < 0.05). The mean hospital stay was significantly shorter in the NPWT group (19.17 ± 2.3 vs. 35.12 ± 3.8 days). Healing rates were higher (91.3% vs. 78.3%), and amputation rates were lower (8.7% vs. 21.7%) in the NPWT group. Conclusion: NPWT demonstrated superior wound healing outcomes compared with 3% hypertonic saline dressing in patients with diabetic foot ulcers. The therapy resulted in enhanced wound contraction, reduced hospitalization, and improved clinical outcomes. These findings support the use of NPWT as an effective treatment modality in the management of diabetic foot ulcers.