Adjunctive Intermittent Vacuum Therapy Is Associated With Faster Healing of Chronic Lower Limb Wounds: A...

Chronic lower limb wounds are especially difficult to heal when further vascular reconstruction is not feasible, yet evidence for noninvasive adjunctive therapies in this population remains limited. Intermittent vacuum therapy (IVT) exposes the limb to alternating negative and positive pressure, but clinical wound-healing evidence is scarce. We evaluated whether adjunctive IVT was associated with faster complete healing in a single-centre retrospective age- and sex-matched cohort. Ninety-four patients treated between December 2019 and June 2022 were included: 47 received IVT plus standard wound care and 47 received standard wound care alone. IVT comprised three 30-40-min sessions weekly. Complete epithelialization was the event; unhealed wounds were censored at the last documented follow-up. Kaplan-Meier analysis and Cox regression stratified by wound aetiology were used. Complete healing occurred in 36 of 47 IVT-treated wounds (76.6%) and 23 of 47 controls (48.9%); the Kaplan-Meier median time to healing was 4.0 versus 17.0 months. After multivariable adjustment, IVT was associated with a higher rate of healing (hazard ratio, 10.73; 95% confidence interval, 4.37-26.38; p < 0.001), and sensitivity analyses supported the direction of the primary association. Because treatment was nonrandomised and clinically important baseline imbalances persisted after matching, residual confounding may substantially affect the magnitude of the estimate. These findings support prospective randomised multicentre evaluation of IVT as an adjunct to standard care.