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Serial surgical debridement: A retrospective study on clinical outcomes in chronic lower extremity wounds
Author(s) -
Cardinal Matthew,
Eisenbud David E.,
Armstrong David G.,
Zelen Charles,
Driver Vickie,
Attinger Christopher,
Phillips Tania,
Harding Keith
Publication year - 2009
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1524-475x.2009.00485.x
Subject(s) - medicine , debridement (dental) , surgery , venous leg ulcer , wound healing , diabetic foot , retrospective cohort study , prospective cohort study , wound care , randomized controlled trial , wound closure , odds ratio , diabetes mellitus , endocrinology
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.