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

Lucia Michailidis, Shan M. Bergin, Terry P. Haines, Cylie M. Williams

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2 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)39-46
Number of pages8
JournalOstomy Wound Management
Issue number9
Publication statusPublished - 1 Sep 2018


  • Debridement
  • Diabetes
  • Foot ulcer
  • Meta-analysis
  • Review

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