title: Which cleansing care is better, foot bath or shower? Analysis of 236 limb ulcers.
abstract: Foot baths and showering are two widely used methods to cleanse limb ulcers. However, some clinicians warn that foot baths may contribute to the spread of infection at the ulcer site. This study aimed to retrospectively investigate the relationship between cleansing methods and the limb prognoses of 236 patients with chronic limb ulcers. These patients were divided into two groups according to the method used to cleanse their ulcers, foot bath and showering. Limb prognosis, including loss of all toes and major amputation, was retrospectively analysed. The rates of loss of all toes and major amputation were 53·0% and 30% in the foot bath group, and 35·3% and 18·4% in the showering group, respectively. The rates of loss of all toes (adjusted odds ratios = 2·07; P = 0·0066; 95% confidence intervals, 1·22-3·50) and major amputation (adjusted odds ratio = 1·90; P = 0·037; 95% confidence intervals, 1·03-3·50) were significantly higher in the foot bath group than those in the showering group. Our results demonstrate that showering is preferable to foot baths for the cleansing of chronic limb ulcers. Clinicians should be cautious that inappropriate cleansing may cause ulcer infections to spread.
authors.affiliation: Department of Surgical Science, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Sano
authors.affiliation: Department of Plastic and Reconstructive Surgery, Saitama Medical University Hospital, Saitama, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ichioka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001494:Baths; D002908:Chronic Disease; D003646:Debridement; D005260:Female; D016523:Foot Ulcer / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014945:Wound Healing
keywords: Chronic ulcer; Infection; Irrigation; Limb prognosis; Limb salvage