Healing rates in diabetes-related foot ulcers using low frequency ultrasonic debridement versus non-surgical sharps debridement: a Randomised Controlled Trial

Ms Lucia Michailidis1,2, Dr Shan Bergin2,3, Prof. Terry Haines3, Dr Cylie Williams1,3

1Peninsula Health, Frankston, Australia, 2Monash Health, Clayton, Australia, 3Monash University, Frankston, Australia

Abstract:

Aims:
This study aimed to determine the proportion of DFUs healed using non-surgical sharps debridement versus low frequency ultrasonic debridement (LFUD).  Secondary aims included quality of life and assessment of ulcer pain.

Method:
Individuals with DFUs attending the Podiatry Department 2013-2015, at a major metropolitan health network in Melbourne, were screened against study eligibility criteria.  Eligible participants were randomly allocated to either the non-surgical sharps debridement (control) group or the LFUD (intervention) group and received weekly treatment for 6 months.  Participants also completed a quality of life questionnaire and visual analogue pain scale at regular time points.

Results:
Ten participants with 14 ulcers received weekly debridement for 6 months.  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 those treated with LFUD (117.6 days ± 40.3).  In both groups, quality of life was observed to improve as ulcers healed and pain reduced after treatment.

Conclusion:
This study resulted in an interesting observation that non-surgical sharps debridement may lead to faster healing of DFUs when compared to LFUD.   However, the small sample size makes it challenging to draw conclusions that will impact clinical practice.  The greatest limitation of this study was the difficulty recruiting participants.   Further research is required to investigate the clinical and economic efficacy of these two debridement modalities in the management of DFUs.

Biography:

Lucia completed a Bachelor of Podiatry at La Trobe University in 2008.  On completion of the degree she was the recipient of an Award for Excellence in clinical practice by the Australian Podiatry Association (Vic) and attained inclusion on the La Trobe University Dean’s Honours List.

She has worked at three of Victoria’s largest health networks over the past eight years and is well experienced in managing the high-risk foot population in the Melbourne Metropolitan area.

Lucia has recently submitted her PhD investigating the use of low frequency ultrasonic debridement compared with non-surgical sharps debridement in the management of diabetes-related foot ulcers.

Healing rates in diabetes-related foot ulcers using low frequency ultrasonic debridement versus non-surgical sharps debridement: a Randomised Controlled Trial.