Introduction. Lower limb wounds are difficult to manage, and Negative pressure wound therapy (NPWT) is proven adjuvant in management of acute wounds. However, there is lack of sufficient high-quality data to prove the benefits of NPWT over conventional dressings in the management of infected wounds of lower limbs in Indian setting. Aims. To determine the effectiveness of NPWT over conventional dressing in the management of infected lower limb wounds. Methods. This prospective study was conducted at a tertiary care centre from February 2020 to August 2021. All patients admitted in the surgical ward with infected lower limb wounds were included and randomly divided into NPWT group (gNPWT) and Conventional Dressing group (gCD). Mean wound area, wound culture and tissue for bacterial load were obtained before and after the study. Data was analysed for statistical significance for mean change in wound area and bacterial load. Subgroup analysis was done for gender, type of wounds, type of organisms isolated, time of presentation and patient problems associated with both type of dressings. A p < 0.05 was considered significant. Results. 48 patients with mean age of 46.83 years and a male preponderance of 3.8:1 were enrolled. Necrotising-infections and compound fractures were the most common etiologies (each = 16%; n = 14). The mean time of presentation and the mean wound area in both groups were not significant. The mean change in wound-area and mean percentage change in wound-area between Day (0) and Day (7) of study in each group with a p < 0.05 was significant. The initial mean bacterial load in the two groups was statistically not significant. The mean difference in wound bacterial load (gNPWT = 16769.13 CFU/ml and gCD = 4440 CFU/ml) and mean percentage change in wound bacterial load (gNPWT = 80.17% and gCD = 35.65%) between Day (0) and Day (7) of study in each group was significant with p < 0.05. The secondary outcome studied that the problems encountered by gNPWT group were significantly less than gCD. Conclusion. NPWT has been instrumental in statistically significant reduction of wound size as well as bacterial load in infected wounds of lower limbs and is found to have better patient compliance by most patients. With more comprehensive studies in future, it can also be classified as a pre-requisite to reconstructive surgeries.
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