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
