Serial surgical debridement: a retrospective study on clinical outcomes in chronic lower extremity wounds.
This investigation was conducted to determine if a correlation exists between wound healing outcomes and serial debridement in chronic venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs). We retrospectively analyzed the results from two controlled, prospective, randomized pivotal trials of topical wound treatments on 366 VLUs and 310 DFUs over 12 weeks. Weekly wound surface area changes following debridement and 12-week wound closure rates between centers and patients were evaluated. VLUs had a significantly higher median wound surface area reduction following clinical visits with surgical debridement as compared with clinical visits with no surgical debridement (34%, p=0.019). Centers where patients were debrided more frequently were associated with higher rates of wound closure in both clinical studies (p=0.007 VLU, p=0.015 DFU). Debridement frequency per patient was not statistically correlated to higher rates of wound closure; however, there was some minor evidence of a positive benefit of serial debridement in DFUs (odds ratio-2.35, p=0.069). Our results suggest that frequent debridement of DFUs and VLUs may increase wound healing rates and rates of closure, though there is not enough evidence to definitively conclude a significant effect. Future clinical research in wound care should focus on the relationship between serial surgical wound debridement and improved wound healing outcomes as demonstrated in this study.
Cardinal
Matthew
M
Advanced BioHealing, La Jolla, California 92037, USA. mcardinal@advancedbiohealing.com
Eisenbud
David E
DE
Armstrong
David G
DG
Zelen
Charles
C
Driver
Vickie
V
Attinger
Christopher
C
Phillips
Tania
T
Harding
Keith
K
D002908:Chronic Disease; D003646:Debridement / Q000379:methods*; D017719:Diabetic Foot / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D012189:Retrospective Studies; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000473:pathology / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology*