الفهرس 
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Abstract
Conclusion
At the end of our study, we concluded that the use of NPWT was better than conventional dressings in the following:
• Time till formation of healthy granulation tissue before graft.
• Time of healing of the graft.
• Percentage of graft take.
• Period of hospitalization.
As regarding color match and texture of the graft, there was no statistically significant difference between the two groups.
Summary
DFU is a common complication of DM that has shown an increasing incidence over previous decades. In total, it is estimated that 15% of patients with diabetes will suffer from DFU during their lifetime.
It is estimated that approximately 20% of hospital admissions among patients with DM are the result of DFU which can lead to infection, gangrene, amputation, and even death, if necessary care is not provided.
Once DFU has developed, there is an increased risk of ulcer progression that may ultimately lead to amputation. Overall, the rate of lower limb amputation in patients with DM is 15 times higher than in patients without diabetes.
Early recognition, proper assessment, prompt intervention, and good follow-up are vital for proper management of DFU.
Very important elements in the general therapeutic policy for diabetic ulcers are good glycemic control, normalization of blood pressure, the management of dyslipidemia, smoking cessation, and appropriate diet. As malnutrition is a major factor impeding normal healing, appropriate nutrition should always be part of the treatment plan.
The development of efficient wound dressings for DFUs is a substantial challenge. An ideal wound dressing should offer protection from secondary infections, provide a moist wound environment, remove wound exudates, and promote tissue regeneration.
NPWT is often used because of its ability to reduce excess moisture in the wound, reducing bioburden and exposure to associated toxins. NPWT also increases cell proliferation (including the proliferation of granulation tissue) and perfusion in the wound bed. NPWT also aids in the contraction of the wound edges by gently stretching the skin.
Application of negative pressure over the wound bed allows the arterioles to dilate, increasing the effectiveness of local circulation, and promoting angiogenesis, which assists in the proliferation of granulation tissue.
The role of negative pressure dressing in the healing of diabetic foot ulcers has been proposed as a novel method of manipulating the chronic wound environment in a way that reduces bacterial burden and chronic interstitial wound fluid, increases vascularity and cytokine expression, and to an extent mechanically exploiting the viscoelasticity of peri-wound tissues.
In our present study, it was concluded that the rate of granulation tissue formation, time of graft healing, and overall graft survival were significantly better in the NPWT group as compared to the conventional dressing group.
It was also seen that the overall hospital stay was significantly less in the NPWT group.
NPWT is a cost-effective, easy to use, and patient-friendly method of treating diabetic foot ulcers which helps in the early closure of wounds, preventing complications and hence promising a better outcome even after skin grafting.