Critical Appraisal of Two Quantitative Research Studies

Critical Appraisal of Two Quantitative Research Studies
Diabetic foot ulcers are a common problem in patients who have diabetes. The wounds require therapy to prevent infections; this includes negative pressure wound therapy or standard moist dressing. In nursing practice, wound care and management are critical as chronic diabetic foot ulcers can lead to sepsis, further necessitating limb amputation. The caregivers require specialized skills to treat persistent diabetic foot ulcers. Wound management is predominantly a nurse-led area, and evidence shows that the nurse' exercise in wound care therapy benefits the patients and reduces healthcare costs. In healthy individuals, acute wounds heal quickly, while in diabetic persons, it takes more time. This paper provides a critical analysis of two quantitative research studies on vacuum-assisted closure dressing on diabetic foot ulcers. The studies include Farooq et al. (2019) study on “Diabetic foot ulcers; a comparison of outcome of Vacuum Assisted Closure (VAC) dressing with wet dressings” and James et al. (2019), “The comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer” study. Negative pressure wound therapy leads to faster healing of diabetic foot ulcers compared to standard moist dressing.
PICOT Question
In patients with stage 3 diabetic ulcers, how does negative pressure wound therapy compared to a standard moist dressing affect wound healing over two months?
Background of Studies
Farooq et al. (2019) article investigates the outcome of vacuum-assisted closure and dressing over the wet dressing. The study was done at the Department of Surgery in Al-Bukyriah General Hospital in a span of three and half years, from June 2012 to December 2016, using 200 patients with diabetic foot ulcers. The patients were randomly classified into two groups, A and B, using the lottery method. Each group had 100 patients. Group A patients received vacuum-assisted closure dressing treatment, while Group B received moist dressing with hydrocolloid gel. All patients below 18 years and having other health complications such as acute ulcers or malignancy were excluded. The wound dressing was done every third day and analyzed weekly, and wound size was measured at the end of the month; the measurement was expressed in percentage. The study is significant to nursing as it provides insight into determining the most effective, safe, and fast therapy for treating diabetic ulcers. Additionally, saving on costs for the patient. The purpose of this study was to compare the rate of wound healing with negative pressure wound therapy to conventional moist dressings in the treatment of sizeable diabetic foot wounds. The objectives were to find the rate of wound healing in each group and to identify changes in wound sizes between patients in both groups. The research question was to know whether vacuum-assisted closure therapy was better than moist dressing when taking care of diabetic foot ulcers.
James et al. (2019) article titled “The comparison of vacuum-assisted closure therapy and conventional dressing on wound healing in patients with diabetic foot ulcer” evaluates the benefit of vacuum-assisted closure therapy in the Indian population. The investigation took two years in South India at a tertiary care center. A randomized control was used on patients with diabetic foot ulcers of Wagner's Grades 1 and 2, and patients were stratified based on diabetic foot ulcer size more significant or less than 10cm. In the study, 136 patients were evaluated and 30 selected, then randomized to get VAC treatment or conventional wound dressing. The study is significant to nurses as it provides awareness on whether bleeding and infection can increase in a VAC therapy. The objective of the study was to identify the time it takes for the wound to heal. Moreover, to establish whether granulation tissue formed using a visual score and whether bleeding and infection decreased. The purpose of the study was to establish the efficacy and safety of VAC in the management of diabetic foot ulcers in an Indian population. The research question behind the study was to find out whether VAC therapy was effective and safe in treating diabetic foot ulcers.
Support for the Nursing Practice Problem
The two articles provide insights into the PICOT question as they demonstrate the effectiveness of VAC negative pressure wound therapy in healing diabetic foot ulcers as compared to standard moist dressing. The article by James et al. (2019) found a significant reduction in healing time and ulcer area in vacuum-assisted therapy. While using VAC, wound healing took 21 days, while conventional...