COMPARATIVE EFFECTIVENESS OF STANDARD WOUND CARE, NEGATIVE PRESSURE WOUND THERAPY, AND BIOENGINEERED SKIN SUBSTITUTES IN DIABETIC FOOT ULCERS: A PROSPECTIVE OBSERVATIONAL STUDY

Background: Diabetic foot ulcers (DFUs) are a debilitating complication of diabetes mellitus, associated with high morbidity, infection risk, and limb amputation. Standard wound care (SWC) often yields suboptimal outcomes in moderate-to-severe DFUs. This study aimed to compare the effectiveness of SWC alone versus its combination with negative pressure wound therapy (NPWT) or bio engineered skin substitutes (BSS) in promoting ulcer healing. Methods: A prospective observational study was conducted at a tertiary care center involving 150 patients with Wagner Grade 1–3 DFUs. Patients were allocated into three treatment groups: SWC, SWC + NPWT, and SWC + BSS. Primary outcome was complete wound healing at 16 weeks; secondary outcomes included time to healing, infection rates, and minor amputation incidence. Results: Complete healing was achieved in 76% of BSS patients and 70% of NPWT patients, significantly higher than the 52% healing rate observed in the SWC group (p = 0.01). Mean time to healing was shorter in BSS (9.7 ± 2.7 weeks) and NPWT (10.2 ± 2.9 weeks) groups compared to SWC (12.4 ± 3.5 weeks; p < 0.01). Infection rates were also reduced in NPWT (10%) and BSS (8%) versus SWC (24%) (p = 0.02). Minor amputations occurred in 2% (BSS), 4% (NPWT), and 10% (SWC) of cases(p=0.04). Conclusion: NPWT and BSS significantly improve healing outcomes in DFUs compared to standard care, reducing healing time, infection risk, and amputation rates. Their incorporation into routine management of advanced DFUs can enhance patient outcomes and healthcare efficiency.