Cutoff Value of The Ankle Brachial Pressure Index for Vacuum-Assisted Closure Application in Diabetic Foot Ulcers

Document Type : Original Article

Authors

Department of Vascular Surgery, Faculty of Medicine, Mansoura University, Egypt

10.21608/ejsur.2024.346489.1322

Abstract

Background: Diabetes Mellitus (DM) is a chronic disease and has been considered a major health concern globally. It
results in significant clinical, economic, social, and quality of life (QoL) issues for patients. Diabetic foot ulcer (DFU)
represents a significant and debilitating complication of DM, affecting 15% of patients. Negative pressure wound therapy
(NPWT) is a non-invasive treatment that facilitates fluid removal from wounds, improves the wound bed for closure,
decreases oedema, and encourages the formation of granulation tissue by applying controlled negative pressure using a
vacuum-assisted closure (VAC) device. This study aimed to determine the ankle-brachial pressure index (ABPI) cutoff
value that indicates a benefit from VAC application for DFUs.
Patients and Methods: A descriptive, single-center, observational, prospective study was performed on diabetic patients.
The study included 56 diabetic patients. All patients underwent three VAC application sessions, and debridement was
performed when needed. The ABPI was measured prior to the first session, and ulcer dimensions were measured both
before and after each session.
Results: This study revealed that the ABPI significantly predicts improvements in the dimensions of DFUs following
vacuum-assisted closure application. The area under the curve was significantly elevated relative to the diagonal reference line (P= 0.028). At a cutoff point of 0.615, the ABPI demonstrated a sensitivity of 71.4% and a specificity of 100.0% (area under curve= 0.762).
Conclusion: Measuring the ABI allows for the prediction of DFUs, which may improve following the application of
VAC. 

Keywords