The impact of manual vacuum-assisted closure technique in wound healing: a case report

Diabetic ulcers are complex wounds that require specialized care. Proper wound care is crucial to prevent amputation, and one effective treatment option is negative pressure wound therapy. However, the cost of negative pressure wound therapy can often be a barrier, making it difficult for caregivers and families to access.

This study aims to develop an alternative system, called the manual vacuum-assisted closure technique, using a 50 cc syringe pump with a pressure value of 93.33 mmHg, to examine the impact of the manual vacuum-assisted closure technique on the continuum of wound status in diabetic ulcers.

A 56-year-old Minangnese man, with a 15-year history of diabetes mellitus and a family history of the disease, presented with a grade IV diabetic ulcer on the dorsal pedis dextra following a postoperative debridement. The wound measured 48 cm² and had an ankle-brachial index value of 1.0 mmHg. The ulcer originated from being pierced by a nail. Previous treatment involved surgical debridement in early January, followed by twice-daily wound care using gauze and 0.9% NaCl, which showed no improvement. Consequently, the wound worsened and became more painful. The patient also had a history of smoking, which he only quit earlier this year. The wound was assessed using the Bates-Jensen Wound Assessment Tool over a period of 21 days.

After daily manual vacuum-assisted closure technique wound treatment for 21 days in diabetic ulcers, there was a noticeable decrease in the Bates-Jensen Wound Assessment Tool scores. Specifically, on day 5, the score was 38; on day 14, the score was 30; and on day 21, the score was 24. The use of the manual vacuum-assisted closure technique in wound treatment demonstrated significant improvements in diabetic ulcers.