***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Venous leg ulcer pain experienced during compression b and aging is poorly understood . A prospect i ve , pilot cohort study was initiated to determine the feasibility of conducting a large-scale , repeated measures cohort study of venous leg ulcer pain and to document and describe the venous leg ulcer pain experience during the first 5 weeks of treatment with compression b and ages . Eligible individuals admitted to a nurse-led community leg ulcer service in one Canadian community were recruited for the 5-week study . Pain assessment tools ( ie , numerical rating scale and short form McGill Pain Question naire ) were evaluated by 20 venous ulcer patients ( mean age = 73.7 years ) and their nurses for ease of use during one baseline and five weekly follow-up visits . Health-related quality of life ( HRQL ) information was obtained . Nurses reported on ease of integrating pain data collection into regular clinical care . Each pain assessment tool was audited for completion . Most participants found the pain assessment tools easy to use , but nurses reported lengthened visit times with some participants as a result of tool administration difficulties , particularly the visual analogue scale ( VAS ) . Overall completeness of pain assessment tools ranged from 85.0 % ( visual analogue scale ) to 96.3 % ( present pain intensity and word descriptor list ) . The vast majority of patients ( 18 ) reported ulcer pain at baseline . Total mean scores for all pain assessment tools used decreased over time , but most patients reported pain throughout the study . The most common pain descriptors used were " aching , " " stabbing , " " sharp , " " tender , " and " tiring . " Health-related quality of life was low and did not change during the 5-week study . The results of this study suggest that the vast majority of venous ulcer patients experience pain and that it is feasible to examine this pain in individuals receiving care in the community over time Abstract Background : Diabetes Mellitus ( DM ) is the most common endocrine disease worldwide . One of the most important chronic complications of this disease is the development of diabetic foot . The management of diabetic foot wounds is quite important with respect to public health . Aims : To determine the effect of Vacuum Assisted Closure ( VAC ) therapy on the quality of life in the treatment of diabetic foot ulcers and compare it with st and art wound care . Methods : Between May 2007 to December 2008 , 67 consecutive patients with diabetic foot ulcers were r and omly assigned to VAC therapy ( Group1 , n : 30 ) or st and art wound care ( Group 2 , n : 37 ) . The SF-36 question naire was administered the day before and in the month following wound healing . Global analyses of the 8 domains and 2 comprehensive indexes of SF-36 , Physical Component Summary ( PCS ) and Mental Component Summary ( MCS ) were performed . Clinical measures included  st and ard antidiabetic treatment , daily wound care including antiseptic bath , debridement , toe removal for gangrene when necessary , and wound care with conventional methods or  VAC . Healing time was calculated as the time from hospital admission to the time of re-epithelization . Results : There were no differences in the  mean age , ulcer size and pulse status of the patients in both groups . Healing time in the VAC group was significantly reduced ( p < 0.05 ) . All 8 domains of SF-36 and MCS and PCS scores improved remarkably after VAC therapy . Conclusion : Vacuum Assited Closure therapy was found to be effective in the treatment of chronic diabetic ulcers . The improvement of quality of life demonstrates a clear-cut indication in this particular group of patients Background : Because of specific method ological difficulties in conducting r and omized trials , surgical research remains dependent predominantly on observational or non‐r and omized studies . Few vali date d instruments are available to determine the method ological quality of such studies either from the reader 's perspective or for the purpose of meta‐ analysis . The aim of the present study was to develop and vali date such an instrument BACKGROUND Current treatment modalities for chronic leg ulcers are time consuming , expensive , and only moderately successful . Recent data suggest that creating a subatmospheric pressure by vacuum-assisted closure ( V.A.C. , KCI Concepts , San Antonio , Texas ) therapy supports the wound healing process . METHODS The efficacy of vacuum-assisted closure in the treatment of chronic leg ulcers was prospect ively studied in a r and omized controlled trial in which 60 hospitalized patients with chronic leg ulcers were r and omly assigned to either treatment by V.A.C. or therapy with conventional wound care techniques . The primary outcome measure was the time to complete healing ( days ) . Statistical analysis was performed on the intention-to-treat basis . RESULTS The median time to complete healing was 29 days ( 95 % confidence interval [ CI ] , 25.5 to 32.5 ) in the V.A.C. group compared with 45 days ( 95 % CI , 36.2 to 53.8 ) in the control group ( P = .0001 ) . Further , wound bed preparation during  V.A.C. therapy was also significantly shorter at 7 days ( 95 % CI 5.7 to 8.3 ) than during conventional wound care at 17 days ( 95 % CI , 10 to 24 , P = .005 ) . The costs of conventional wound care were higher than those of V.A.C. Both groups showed a significant increase in quality of life at the end of therapy and a significant decrease in pain scores at the end of follow-up . CONCLUSIONS V.A.C. therapy should be considered as the treatment of choice for chronic leg ulcers owing to its significant advantages in the time to complete healing and wound bed preparation time compared with conventional wound care . Particularly during the preparation stage , V.A.C. therapy appears to be superior to conventional wound care techniques OBJECTIVE To discover the impact of topical negative pressure ( TNP )  on quality of life . METHOD An exploratory prospect i ve cohort study was conducted on 26 patients undergoing TNP .  The Cardiff Wound Impact Schedule ( CWIS ) , a wound-specific tool , was used to investigate quality -of-life scores before therapy and four weeks after therapy or at wound closure . Wound dimensions were measured at both assessment s , and the values for the CWIS domains ( physical symptoms , social functioning , well-being and overall quality of life ) were investigated using parametric and non-parametric tests . RESULTS The mean duration of TNP therapy was 3.3 + /- 1.7 weeks . Topical negative pressure therapy helped to achieve complete wound closure in 14 patients ( 54 % ) , and there was a mean reduction in wound surface area from 52.2 cm2 ( range 4 - 150 ) to 26.8 cm2 ( 0 - 120 ) . While there was no significant change in quality of life in patients whose wounds healed ( 1 + /- 11.9 ) , the physical-functioning domain improved in obese patients ( 20 + /- 21 , p < 0.05 ) and worsened in ambulatory patients ( -3 + /- 13 , p < 0.05 ) . The portableTNP system had no significant impact on quality of life ( -3 + /- 16 ) , while the global quality -of-life score worsened with surgical intervention ( -0.5 + /- 2 , p < 0.05 ) . CONCLUSION Although TNP aids wound closure in patients with complex wounds , in selected cases their quality of life can worsen . This is the first exploratory cohort study of its kind , and has identified an urgent need to vali date the use of patient-based outcome measures in TNP therapy . Such data can be useful in allocating re sources and justifying funding in wound care 
    Output:
    
QoL in the NPWT group was lower in the first week , though no difference in QoL was observed thereafter .
This systematic review observed that QoL improved at the end of therapy independent of which therapy was used .
NPWT led to a lower QoL during the first week of treatment , possible due to aniexty , after which a similar or better QoL was reported when compared with SWC .
It could be suggested that NPWT might be associated with increased anxiety .