***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: The purpose of this study was to compare the ultraportable mechanically powered Smart Negative Pressure ( SNaP ( ® ) ) Wound Care System to the traditional electrically powered Vacuum-Assisted Closure ( VAC ( ® ) ) Therapy System in the treatment of chronic lower extremity wounds . This 12-center r and omized-controlled trial of patients with noninfected , nonischemic , nonplantar lower extremity wounds had enrolled 65 patients , as of January 5 , 2010 , at the time of a planned interim analysis . Subjects were r and omly assigned to treatment with either the SNaP ( ® ) or VAC ( ® ) Systems . The trial evaluated treatment for up to 16 weeks or till complete closure was achieved . Fifty-three patients ( N=27 SNaP ( ® ) , N=26 VAC ( ® ) ) completed at least 4 weeks of therapy . Thirty-three patients ( N=18 SNaP ( ® ) , N=15 VAC ( ® ) ) completed the study with either healing or 16 weeks of therapy . At the time of planned interim analysis , no significant differences ( p=0.99 ) in the proportion of subjects healed between the two devices evaluated were found . In addition , the percent wound size reduction between treatment groups was not significantly different at 4 , 8 , 12 , and 16 weeks , with noninferiority analysis at 4 weeks of treatment reaching the p-value < 0.05 significance level ( * p=0.019 ) . These interim data suggest no difference in wound closure  between the SNaP ( ® ) System and the VAC ( ® ) System in the population studied . We look forward to the final analysis results Background : Vacuum-assisted closure therapy is a relatively new concept described in the literature that increases wound-healing capacity . The authors aim ed to investigate the effect of vacuum-assisted closure therapy on wound healing , granulation tissue formation , bacterial clearance , pain , time involvement of the staff , and total costs in all types of wounds in comparison with modern wound dressings . Methods : Sixty-five patients with a chronic or acute wound were r and omized to initial treatment with vacuum-assisted closure or modern dressings .  The authors ’ primary endpoint was a granulated wound or a wound ready for skin grafting or healing by secondary intention . Results : The time to the primary endpoint with  vacuum-assisted closure therapy  was not significantly shorter , except for patients with cardiovascular disease and /or diabetics . Vacuum-assisted closure therapy did not result in significantly faster granulation or wound surface reduction or better bacterial clearance , but patient comfort was an important advantage . Time involvement and costs of nursing staff were significantly lower for the vacuum-assisted closure therapy , but overall costs were similar for both groups . Conclusions : With vacuum-assisted closure therapy , wound healing is at least as fast as with modern wound dressings . Especially cardiovascular and diabetic patients benefit from this therapy . The total costs of vacuum-assisted closure are comparable to those of modern wound dressings , but the advantage is its comfort for patients and nursing staff Vacuum-assisted closure has become a new technique in the challenging management of contaminated , acute , and chronic wounds . Although promising clinical results have been described , scientific proof to substantiate the mechanism of action of this therapy is scarce . In the present study , we examined whether the positive effect on wound healing found in vacuum-assisted closure-treated wounds could be explained by an effect on the bacterial load . Fifty-four patients who needed open wound management before surgical closure were included in this study . Wounds were r and omized to either vacuum-assisted closure therapy ( n= 29 ) or treatment by conventional moist gauze therapy ( n= 25 ) . Healing was characterized by development of a clean granulating wound bed ( " ready for surgical therapy " ) and reduction of wound surface area . To quantify bacterial load , biopsies were collected . No significant difference was found in time needed to reach " ready for surgical therapy " comparing both therapies . Wound surface area reduction was significantly larger in vacuum-assisted closure-treated wounds : 3.8 + /- 0.5 percent/day ( mean + /- SEM ) compared to conventional-treated wounds ( 1.7 + /- 0.6 percent/day ; p < 0.05 ) . The total quantitative bacterial load was generally stable in both therapies . However , nonfermentative gram negative bacilli showed a significant decrease in vacuum-assisted closure-treated wounds ( p < 0.05 ) , whereas Staphylococcus aureus showed a significant increase in vacuum-assisted closure-treated wounds ( p < 0.05 ) . In conclusion , this study shows a positive effect of  vacuum-assisted closure therapy  on wound healing , expressed as a significant reduction of wound surface area . However , this could not be explained by a significant quantitative reduction of the bacterial load OBJECTIVE Topical negative pressure ( TNP ) ( vacuum therapy ) is frequently used in the management of acute , traumatic , infected and chronic full-thickness wounds . This prospect i ve clinical r and omised trial compared the costs of TNP with conventional therapy ( moist gauze ) in the management of full-thickness wounds that required surgical closure . METHOD The direct medical costs of the total number of re sources needed to achieve a healthy , granulating wound bed that was ' ready for surgical therapy ' were calculated . RESULTS Fifty-four patients admitted to a department of plastic and reconstructive surgery were recruited into the trial . Cost analysis showed significantly higher mean material expenses for wounds treated with TNP ( 414euros+/-229euros [ SD ] ) compared with conventional therapy ( 15euros+/-11euros ; p<0.0001 ) , but significantly lower mean nursing expenses ( 33euros+/-31 euros and 83euros+/-58euros forTNP and conventional therapy respectively ; p<0.0001 ) . Hospitalisation costs were lower in theTNP group ( 1788euros+/-1060euros ) than in the conventional treatment group ( 2467euros+/-1336euros ; p<0.043 ) due to an on average shorter duration until they were'ready for surgical therapy ' . There was no significant difference in total costs per patient between the two therapies ( 2235euros+/-1301euros for TNP versus 2565euros+/-1384euros for conventional therapy ) . CONCLUSION TNP had higher material costs . However , these were compensated by the lower number of time-consuming dressing changes and the shorter duration until they were ' ready for surgical therapy ' , result ing in the therapy being equally as expensive as conventional moist gauze . DECLARATION OF INTEREST This work was partly supported by the Plastic and Reconstructive Surgery Esser Foundation , and KCI Medical , Houten , The Netherl and s. The authors have no conflicts of interest Wound closure using topical negative pressure ( TNP ) has been reported to be effective , but equipment costs can be prohibitive in re source -challenged countries . Because nonhealing wounds are exceedingly common in developing countries such as India , the ability to optimize wound care with limited re sources is very important . To investigate the feasibility and efficacy of providing TNP in an Indian medical referral center , a r and omized controlled trial comparing a locally constructed TNP device ( treatment ) to wet-to-dry gauze dressings ( control ) was conducted . Eligible study participants ( N = 48 ) were recruited from the inpatient wards . Wound etiologies included diabetic foot ulcers ( 15 ) , pressure ulcers ( 11 ) , cellulitis/fasciitis ( 11 ) , and " other " ( 11 ) . Following enrollment , wound size was assessed using computer-aided measurements of digital photographs and block-r and omized to the study arms using a concealed allocation table . Wounds in both treatment groups were débrided before dressing application and patients were followed until wound closure or being lost to follow-up for an average of 26.3 days ( + /- 18.5 ) in the control and 33.1 days ( + /- 37.3 ) in the treatment group . No statistically significant differences in time to closure between the two treatment groups were observed except in a subset analysis of pressure ulcers ( mean 10 + /- 7.11 days for treatment and 27 + /- 10.6 days in control group , P = 0.05 ) . Direct costs to close a pressure ulcer also were lower in the TNP than in the control group . A review of the literature suggests the outcomes obtained using a locally constructed TNP device are similar to those obtained using commercially available devices . As a result of this study , a dedicated tissue viability team has been established to identify wounds suitable for TNP , oversee treatment , monitor the need for surgical débridement , and employ wound healing principles and technology appropriately . These results suggest that inexpensive material s can be utilized for TNP wound closure in a developing country Diabetic foot wounds present a great challenge to wound care practitioners . The objective of this pilot study was to determine whether vacuum-assisted closure ( V.A.C. ) therapy would afford quicker wound resolution as compared to saline-moistened gauze in the treatment of postoperative diabetic foot wounds . Ten patients were r and omized into either the  experimental V.A.C.  group or control saline gauze  group . Included in the study were diabetic patients 18 to 75 years of age who had a nonhealing foot ulceration . Excluded were those patients with venous disease , coagulopathy , or those who had active infections not resolved by initial surgical debridement . All foot ulcers were surgically debrided prior to initiation of V.A.C. or gauze treatment . In the experimental group , V.A.C. dressings were applied in accordance with manufacturer 's protocol for chronic wounds and changed every 48 hours . In the control group , saline gauze dressings were applied at the time of surgical debridement and changed twice a day thereafter . Measurements and photos were obtained to document wound progress . Main outcome measures included : 1 ) time to satisfactory healing ( calculated from date of initial debridement to date of definitive closure , and 2 ) change in wound surface area ( calculated from initial wound tracing to final tracing ) . Satisfactory healing in the V.A.C. group was achieved in 22.8 ( + /- 17.4 ) days , compared to 42.8 ( + /- 32.5 ) days in the control group . Surface area changes of 28.4 % ( + /- 24.3 ) average decrease in wound size in the V.A.C. group , compared to a 9.5 % ( + /- 16.9 ) average increase in the control group during measurement period OBJECTIVE To evaluate the clinical efficacy of Negative Pressure Wound Therapy ( NPWT ) using Vacuum Assisted Closure ( VAC ) compared with Advanced Moist Wound Therapy ( AMWT ) to treat Diabetic Foot Ulcer ( DFU ) . STUDY DESIGN R and omized control trial . PLACE AND DURATION OF STUDY Surgical Department , Combined Military Hospital ( CMH ) / Military Hospital ( MH ) , Rawalpindi , from November 2010 to June 2012 . METHODOLOGY The study consisted of 278 patients , with 139 patients each in Group ' A ' and ' B ' , who were subjected to AMWT and NPWT , respectively . Wound was assessed digitally every week for 2 weeks . Wound dimension and surface area were determined using University of Texas Health Centre at San Antonio ( UTHCSA ) image tool version 3.0 . Efficacies of AMWT and NPWT were compared in terms of reduction in wound area over 2 weeks . RESULTS Mean age of presentation in group A was 55.88 ± 10.97 years while in group B , it was 56.83 ± 11.3 ( p=0.48 ) . Mean duration of diabetes at presentation was 15.65 ± 4.86 and 15.96 ± 5.79 years in group A and B , respectively ( p=0.74 ) . Majority of patients had Wagner 's grade 2 ulcer ( 82 % in group A and 87.8 % in group B , p= 0.18 ) . Initial wound size in group A was 15.07 ± 2.92 cm2 and in group B 15.09 ± 2.81 cm2 ( p = 0.95 ) . Wound size measured after 2 weeks , treatment was in group A13.70 ± 2.92 cm2 and in group B 11.53 ± 2.78 cm2 ( p < 0.001 ) . Wound area reduction in both groups revealed statistically significant faster healing in group B as compared to group A ( p < 0.001 ) . CONCLUSION NPWT using VAC was more efficacious  than AMWT in the management of diabetic foot ulcers Objective To compare the effectiveness of vacuum-assisted closure ( VAC ) versus conventional dressings in the healing of  diabetic foot ulcerations ( DFUs ) in terms of healing rate ( time to prepare the wound for closure either spontaneously or by surgery ) , safety , and patient satisfaction . Methods R and omized case – control study enrolling 56 patients , divided into two groups . Group A ( patients treated with VAC ) and Group B ( patients treated with conventional dressings ) , with an equal number of patients in each group . DFUs were treated until wound closure , either spontaneously , surgically , or until completion of the 8-week period . Results Granulation tissue appeared in 26 ( 92.85 % ) patients by the end of Week 2 in Group A , while it appeared in 15 ( 53.57 % ) patients by that time in Group B.  
    Output:
    
There is some evidence to suggest that  negative pressure wound therapy  is more effective in healing post-operative foot wounds and ulcers of the foot in people with DM compared with moist wound dressings .