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

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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
Volume64
Issue number9
DOIs
Publication statusPublished - 1 Sep 2018

Keywords

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

Cite this

@article{d871d60fa95641f48f88fdbd2836b6c9,
title = "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",
abstract = "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.",
keywords = "Debridement, Diabetes, Foot ulcer, Meta-analysis, Review",
author = "Lucia Michailidis and Bergin, {Shan M.} and Haines, {Terry P.} and Williams, {Cylie M.}",
year = "2018",
month = "9",
day = "1",
doi = "10.25270/owm.2018.9.3946",
language = "English",
volume = "64",
pages = "39--46",
journal = "Ostomy Wound Management",
issn = "0889-5899",
number = "9",

}

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

In: Ostomy Wound Management, Vol. 64, No. 9, 01.09.2018, p. 39-46.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - 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

AU - Michailidis, Lucia

AU - Bergin, Shan M.

AU - Haines, Terry P.

AU - Williams, Cylie M.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - 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.

AB - 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.

KW - Debridement

KW - Diabetes

KW - Foot ulcer

KW - Meta-analysis

KW - Review

UR - http://www.scopus.com/inward/record.url?scp=85054131654&partnerID=8YFLogxK

U2 - 10.25270/owm.2018.9.3946

DO - 10.25270/owm.2018.9.3946

M3 - Article

VL - 64

SP - 39

EP - 46

JO - Ostomy Wound Management

JF - Ostomy Wound Management

SN - 0889-5899

IS - 9

ER -