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Michailidis L, Bergin SM, Haines TP, Williams CM, et al.
Ostomy/wound management. Date of publication 2018 Sep 1;volume 64(9):39-46.
1. Ostomy Wound Manage. 2018 Sep;64(9):39-46. A Systematic Review to Compare the Effect of Low-frequency Ultrasonic Versus Nonsurgical Sharp Debridement on the Healing Rate of Chronic Diabetes-related Foot Ulcers. Michailidis L(1), Bergin SM(2), Haines TP(3), Williams CM(4). Author information: (1)Monash Health, Podiatry Department, Monash Medical Centre, Clayton, VIC, Australia; Monash University, School of Primary and Allied Health Care, Physiotherapy Department, Frankston, VIC, Australia. (2)Monash Health, Podiatry Department, Monash Medical Centre, Clayton, VIC, Australia. (3)Monash University, School of Primary and Allied Health Care, Physiotherapy Department, Frankston, VIC, Australia. (4)Monash University, School of Primary and Allied Health Care, Physiotherapy Department; Allied Health Research, Peninsula Health, Allied Health, Frankston, VIC, Australia. Management of diabetes-related foot ulcers often involves debridement of devitalized tissue, but evidence regarding the most effective debridement method is limited.PURPOSE: A systematic review was conducted to determine the effectiveness of nonsurgical sharp debridement (NSSD) versus low-frequency ultrasonic debridement (LFUD) for diabetes-related foot ulceration in adults. METHOD: Published studies (earliest date available to April 2017) comparing healing outcomes of LFUD- and NSSD-treated foot ulcers in adults were considered. The quality of publications that met inclusion criteria were assessed using the PEDro scale, and a meta-analysis was undertaken to compare percentage healed and percentage of ulcer size reduction. RESULTS: Of the 259 publications identified, 4 met the inclusion criteria but 2 of the 4 did not contain sufficient patient outcomes details for meta-analysis, leaving a sample size of 173 patients. Outcome data for the 2 studies included percentage of ulcers healed between the 2 debridement methods. This difference was not significant (RR = 0.92; 95% CI = 0.76-1.11). The risk of bias for both studies was low. CONCLUSION: No difference in healing outcomes between NSSD and LFUD debridement of diabetic foot ulcers was found. Well-designed, controlled clinical studies are needed to address the current paucity of studies examining the efficacy and comparative effectiveness of debridement methods. PMID: 30256750
Appears in following Topics:
Diabetic Foot Ulcer - Treatment
Diabetic Foot Ulcer - Treatment