Combined cytokine therapy and modified vacuum therapy in the treatment of chronic non-healing wounds in neuropathic diabetic foot syndrome: a comparative study

Objective: to assess the effectiveness of combined recombinant interleukin-2 therapy and modified vacuum therapy in patients with chronic non-healing wounds associated with neuropathic diabetic foot syndrome.

Methods: a comparative study included 36 patients with neuropathic diabetic foot syndrome divided into the main and control groups, 18 patients each. After wound debridement, the main group received local recombinant interleukin-2 therapy combined with modified vacuum therapy, whereas the control group received conventional local treatment. Pain intensity on the visual analogue scale, microbial contamination, time to wound cleansing, time to granulation and marginal epithelialization, length of hospital stay, major amputation, and in-hospital mortality were assessed. In addition, IL-2, IL-6, IL-8, and TNF-α were measured before treatment and on days 1, 5, and 10.

Results: the groups were comparable with respect to age, body mass index, diabetes duration, HbA1c, ulcer duration, wound area, and baseline TcPO2. The main group demonstrated lower pain intensity, faster reduction of microbial contamination, and significantly shorter time to wound cleansing, granulation, and marginal epithelialization. By day 10, IL-2, IL-8, and TNF-α levels were lower in the main group. Differences in major amputation and in-hospital mortality favored the main group numerically, but were not statistically convincing.

Conclusion: combined cytokine therapy and modified vacuum therapy were associated with faster wound cleansing, accelerated granulation and epithelialization, lower microbial burden, and a more pronounced decrease in selected pro-inflammatory cytokines by day 10 of treatment.

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