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

BACKGROUND: 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. AIM: 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. CASE PRESENTATION: 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. CONCLUSION: 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.

The Effect of Intradialytic Range of Motion Exercise on Dialysis Adequacy and Fatigue in Hemodialysis Patients.

BACKGROUND: Many hemodialysis patients experience fatigue as a result of not achieving dialysis adequacy. PURPOSE: This study was designed to determine the effect of intradialytic range-of-motion exercises on dialysis adequacy and fatigue in patients undergoing hemodialysis. METHODS: In this two-arm experimental study with repeated measures, participants were allocated to treatment ( n = 25, 23 completed) and control ( n = 25, 24 completed) groups using computerized simple random sampling. Participants in the treatment group performed 30-minute weekly intradialytic exercise sessions in addition to receiving standard care, whereas those in the control group received standard care only. RESULTS: Fatigue and dialysis characteristics were reported at baseline, at the midpoint (end of Week 4), and at the end of Week 8. Whereas mean Kt/V (dialysis adequacy) and urea reduction ratio increased and the fatigue level decreased in the treatment group, these variables did not change in the control group. Significant mean differences in Kt/V, urea reduction ratio, and fatigue between the groups were observed at the end of Week 8. CONCLUSIONS: Intradialytic range-of-motion exercises are recommended for patients undergoing hemodialysis to increase dialysis adequacy and reduce fatigue.