Healing rates in diabetes-related foot ulcers using low frequency ultrasonic debridement versus non-surgical sharps debridement: a randomised controlled trial

Abstract

ObjectiveCurrent clinical practice varies around debridement techniques used to promote healing of diabetes-related foot ulcers. This randomised controlled study will compare healing rates for diabetes-related foot ulcers treated with low frequency ultrasonic debridement versus non-surgical sharps debridement. Individuals with diabetes-related foot ulcers being managed by podiatry at a metropolitan hospital were screened against study criteria. Eligible participants were randomly allocated to either the non-surgical sharps debridement group or the low frequency ultrasonic debridement group and received weekly treatment for 6 months. Participants also completed a quality of life measure and visual analogue pain scale.ResultsThis trial was ended early due to recruitment issues. Ten participants with 14 ulcers participated. Results were analysed using a survival analysis approach. Ulcers treated with non-surgical sharps debridement healed more quickly (61.6 days ± 24.4) compared with low frequency ultrasonic debridement (117.6 days ± 40.3). In both groups, quality of life was observed to improve as ulcers healed and pain levels reduced as ulcers improved. Observations from this study found faster healing using non-surgical sharps debridement. However, these results are unable to be generalised due to the small sample size. Further research is recommended.Trial registration Australian New Zealand Clinical Trial Registry: ACTRN12612000490875

Cellular Proliferation, Dermal Repair, and Microbiological Effectiveness of Ultrasound-Assisted Wound Debridement (UAW) Versus Standard Wound Treatment in Complicated Diabetic Foot Ulcers (DFU): An Open-Label Randomized Controlled Trial

“…In our study population, the time it took for ulcers to heal was significantly shorter in the UAW group than in the surgical group. In a RCT by Michailidis et al [ 32 ], they observed faster healing in DFU patients receiving non-surgical sharps debridement versus patients receiving UAW debridement. However, their results are unable to be generalized due to the small sample size.…”

Ultrasound‐mediated therapies for the treatment of biofilms in chronic wounds: a review of present knowledge

“…The efficacy of this treatment modality has been assessed in a number of clinical trials, which generally concur that ultrasonic debridement is a valuable wound care adjuvant (Amini et al ., ; Murphy et al ., ). It is important to note that although these trials have demonstrated that ultrasonic debridement improves short‐term treatment outcomes, the frequency and total duration of the treatment are comparable to non‐surgical sharp debridement with no significant difference in healing rate between the modalities after 6 months of treatment (Amini et al ., ; Michailidis et al ., ).…”

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“…New trends that have been subjects of interest recently include the negative-pressure wound therapy where tissues are healed in a given vacuum, getting rid of inflammations in the process [3]. Specialists of plastic surgery have also been involved in the treatment of pressure ulcers through the application of pedicled flaps [10]. Failure to treat pressure ulcers increase the risk of developing a malignant cancerlike ulcer called Marjolin's cancer [23].…”

“…Thirty patients had only one infected region, 11 had two areas, four patients had ulcers in three regions, and one male had decubitus in four regions [10]. It was also noted that some of the patients with multiple pressure ulcers received reconstructive surgeries at different stages as per the developing sores, which occurred at various times as well [11].…”