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Debridement of diabetic foot ulcersEdwards J
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SummarySurgical and non-surgical methods of cleaning and removing dead tissue from sores on the feet of people with diabetes.People with diabetes often develop foot ulcers (open sores on the feet that go through the skin), which can lead to serious complications. Cleaning and removing dead tissue from the ulcers is a common procedure also know as "debridement". Debridement may also include the removal of calluses which may surround or 'roof over' the ulcer and can be done in several ways, including surgery and special gels (such as hydrogels). The review found that diabetic foot ulcers heal faster when a hydrogel is used instead of gauze or standard care.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 3, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
October 21. 2002 AbstractBackgroundFoot ulceration is thought to affect 15% of people with diabetes at some time in their lives. Debridement is widely regarded as an effective intervention to speed up ulcer healing. The most effective method is unclear. ObjectivesThe aim of this review is to assess the evidence for the effectiveness of debridement as a treatment for diabetic foot ulcers. Search strategyWe searched the Cochrane Wounds Group Specialised Register (May 2007) and the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2007). We performed hand searches of journals and reference lists. Selection criteriaRandomised controlled trials evaluating a method of debridement in the treatment of diabetic foot ulcers and measuring complete healing or rate of healing. There was no restriction on articles/trials based on language or publication status. Data collection and analysisData extraction and assessment of study quality were undertaken by one author and checked by an Editor of the Wounds Group. Main resultsSix RCTs of debridement were identified; three RCTs assessed the effectiveness of hydrogel for debridement, one RCT evaluated surgical debridement, one RCT compared two different hydrogels and one RCT evaluated larval therapy. Pooling the three hydrogel RCTs suggested that hydrogels are significantly more effective than gauze or standard care in healing diabetic foot ulcers (Relative Risk 1.84, 95% Confidence Interval (CI)1.3 to 2.61). Surgical debridement and larval therapy showed no significant benefit over standard treatment and hydrogel respectively in these small trials. Other debridement methods such as enzyme preparations or polysaccharide beads have not been evaluated in diabetic foot ulcers. Authors' conclusionsThere is evidence to suggest that hydrogel increases the healing rate of diabetic foot ulcers compared with gauze dressings or standard care. More research is needed to evaluate the effects of a range of widely used debridement methods and of debridement per se. |
