Comparative Effectiveness of Continuous Versus Intermittent Negative Pressure Wound Therapy in the Management of Diabetic Foot Ulcers: A Prospective Observational Study.

Introduction Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus, contributing to increased morbidity, risk of amputation, and healthcare burden. Negative pressure wound therapy (NPWT) has emerged as a cornerstone in DFU management, but the comparative effectiveness of continuous versus intermittent NPWT remains unclear. This prospective observational study compares continuous and intermittent NPWT in patients with Wagner Grade 1-2 DFUs, assessing healing time (primary outcome), infection recurrence, and amputation rates (secondary outcomes). Methods This prospective observational study enrolled 110 patients with DFUs in the Department of General Surgery at Sree Balaji Medical College and Hospital, a tertiary care center in Chennai, India. Patients were divided into two groups, i.e., 55 received continuous NPWT and 55 received intermittent NPWT, based on inpatient registration numbers. Wound healing was assessed using the Bates-Jensen Wound Assessment Tool (BWAT) at baseline and weekly intervals. Key variables analyzed included healing time, ulcer progression, infection recurrence, and amputation rates. Statistical analysis involved t-tests, chi-square tests, logistic regression, and Kaplan-Meier survival analysis. Results The mean healing time was significantly lower in the continuous NPWT group (35.2 ± 9.4 days) compared to the intermittent group (42.7 ± 10.5 days, p < 0.001). Logistic regression identified infection absence (OR: 3.21, p < 0.001), Wagner grade ≤2 (OR: 2.87, p < 0.001), HbA1c <8% (OR: 2.15, p = 0.002), and regular use of protective footwear (OR: 1.87, p = 0.013) as independent predictors of successful healing. Continuous NPWT was associated with fewer wound failures and lower amputation rates. was the most commonly isolated organism from infected wounds. Conclusion Continuous NPWT demonstrates superior outcomes in wound healing, infection control, and amputation prevention compared to intermittent NPWT in DFU patients. Optimizing patient-specific factors such as glycemic control, infection status, and ulcer grading further enhance therapeutic efficacy.