A Randomized controlled trial Comparing Vacuum-Assisted Dressing and Conventional Dressing in the Management of Complicated Skin and Soft Tissue Infections

Abstract

Complicated skin and soft tissue infections (SSTIs) are associated with delayed wound healing, prolonged hospital stay, and Increased morbidity. Conventional dressings have traditionally been used for wound management. However, vacuum assisted dressing, also known as negative pressure wound therapy (NPWT) has emerged as an effective modality that promotes granulation tissue formation and enhances wound healing.

Objectives: To compare the efficacy of vacuum-assisted dressing vs conventional dressing in the treatment of Complicated skin and soft tissue infections.

This prospective randomized controlled study was conducted in Department of General Surgery at Deen Dayal Upadhyay Hospital, New Delhi. Forty patients with complicated skin and soft tissue infections were randomly allocated into two groups: vacuum-assisted dressing (n = 20) and conventional dressing (n = 20). The primary outcome was the rate of granulation tissue formation expressed as percentage of ulcer surface area. Secondary outcomes included time required for wound bed preparation and duration of hospital stay. Statistical analysis was performed using SPSS version 23.

Results: Granulation tissue formation was significantly higher in the NPWT group compared to the conventional dressing group. Mean granulation tissue growth at day 4 was 7.88% in the NPWT group compared to 5.00% in the conventional group (p <0.001). At day 8, granulation formation increased to 37.72% in NPWT versus 23.96% in the conventional group (p=0.001). By day 12, granulation tissue formation reached 69.24% in NPWT compared to 48.28% in the conventional group (p =0.003). At day 16, NPWT demonstrated 83.72% granulation compared to 62.76% in conventional dressing (p =0.011).

Conclusion: Negative pressure wound therapy significantly enhances granulation tissue formation and accelerates wound bed preparation compared to conventional saline dressing in complicated SSTIs

Keywords: Negative pressure wound therapy; vacuum-assisted dressing; conventional dressing; skin and soft tissue infection; wound healing