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Impact on wound healing and efficacy of various leg ulcer debridement techniques
Author(s) -
Doerler Martin,
ReichSchupke Stefanie,
Altmeyer Peter,
Stücker Markus
Publication year - 2012
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/j.1610-0387.2012.07952.x
Subject(s) - debridement (dental) , wound healing , leg ulcer , medicine , skin ulcer , surgery
Summary Aim : To evaluate the evidence on the impact of different debridement techniques on healing and their efficacy in the treatment of leg ulcers. Methods : Web‐based search (PubMed) for trials investigating surgical, enzymatic, autolytic, osmotic, ultrasound‐assisted, and biosurgical wound debridement on leg ulcers with regard to healing and efficacy. Results : Both surgical and hydrosurgical methods proved to be effective debridement techniques. For conventional surgical debridement, a significantly greater reduction of the wound surface area and a higher healing rate were reported. Studies on autolytic, osmotic, and enzymatic wound debridement showed effective debridement for krill enzymes, dextranomer and manuka honey. Only for manuka honey was there a significantly greater reduction of the wound surface area compared to standard treatment. One study comparing fibrinolysin/DNAse with placebo and one comparing autolytic with enzymatic debridement showed no significant differences between the respective techniques. Trials on ultrasound‐assisted wound debridement reported a positive impact on healing. A significant wound surface area reduction was demonstrated in one of them. Maggot therapy led to effective debridement. The largest trial showed no significantly improved healing. Conclusions : Further studies are needed to strengthen the evidence for a significant impact of wound debridement on the healing of leg ulcers.