Abstract Introduction Diabetic foot ulcers (DFUs) are a significant cause of morbidity, with many cases refractory to standard therapies. While vacuum-assisted closure (VAC) is effective, combining it with topical oxygen therapy (TOT) may enhance healing. This study compares the efficacy of vacuum-assisted topical oxygen therapy (VATO) versus VAC alone in DFU management. Methods In this prospective study, 60 patients (73.3% male, mean age 44.2 years) with Wagner class 1–4 DFUs, randomised into Group A (VATO: 5-minute TOT of 100% oxygen at 3 L/min 30-minute action time + 3-hour VAC at −100 to −120 mmHg)or Group B (VAC alone). Cycles were repeated overnight for 15 days (three 5-day cycles). Wound healing was assessed using the Bates-Jensen Wound Assessment Tool (BWAT) on days 0, 5, 10, and 15. Results Group A showed superior healing, with significant improvements in wound depth(P = 0.012), edge healing(P = 0.007), reduction of undermining(P = 0.001), necrotic tissue reduction(P = 0.043), exudate control(P = 0.001), granulation tissue formation(P = 0.001), epithelialization(P = 0.001) and reduction of peripheral tissue edema(P = 0.002). Wound infection rates (26.66 versus 40%) and re-debridement needs (6.66 versus 13.33%) were lower in Group A, though not statistically significant. No adverse events occurred. Conclusions Customized VATO therapy significantly enhances wound healing versus VAC alone, particularly in granulation, epithelialization, and exudate control. This low-cost approach may be a feasible adjunct in resource-limited settings. Larger trials are warranted to assess long-term outcomes.
Sharon et al. (Sun,) studied this question.