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Effect of ultrasound-assisted debridement on wound healing and infection outcomes in diabetic foot

Objective The objective of this study was to determine the efficacy of low-frequency ultrasound (LFU) in chronic wound healing and infection outcome in diabetic foot ulcers. Background Around 15% of patients with diabetes will develop foot ulcers at some point in their life, making them 30–40 times more likely to undergo amputation due to a nonhealing foot ulcer than the nondiabetic population. Debridement plays a significant role in the healing of diabetic foot ulcers. Patient and methods This randomized clinical trial was conducted on 46 patients with diabetes, recruited from the Diabetic Foot Clinic at Mansoura and Menoufia Universities, Egypt. All patients with diabetes (type I and type II) who had chronic diabetic foot ulcers without severe arterial insufficiency, with ankle brachial indices of at least 0.6, and without severe limb-threatening infections were included. Results Patients were divided into two groups – group 1 received ultrasound-assisted wound (UAW) therapy in conjunction with standard wound care (n = 23), and the other group received only standard wound care. Patients were followed-up for 3 months. The complete healing rate in the present study population was 30.34% (control group = 17.39%, UAW group = 43.47%). The mean wound size reduction was significantly higher in the UAW group only in the second-week and third-month follow-ups. The number of infected ulcers was reduced by ultrasound debridement more than surgical debridement (control group = 5, UAW group = 11) at the end of the study, but with no significant difference (P = 0.148). A significant difference in healing ratio was found in patients with ultrasound debridement and initial wound culture (P = 0.01). Conclusion In diabetic foot ulcers, LFU debridement accompanied by standard wound care has a beneficial effect on wound healing and wound infection. LFU debridement can initially accelerate ulcer healing; however, there was no significant difference between the two modalities in the healing rate after 3 months.