Authors' recommendations: This report identified evidence that autolytic (hydrogel) and enzymatic debridement (clostridial collagenase ointment) are more clinically effective wound debridement procedures for the treatment of diabetic foot ulcers than standard wound care. This is supported by RCTs with important limitations including a moderate to high risk of bias. No clinical effectiveness evidence was found for callus debridement for the prevention and treatment of diabetic ulcers. The cost-effectiveness data identified suggests that clostridial collagenase ointment is more cost-effective than saline moist gauze for the debridement of diabetic foot ulcers, however the cost-effectiveness analysis has some important limitations. No clear consensus was present in the identified guidelines regarding diabetic foot ulcer debridement. Three different guidelines contained recommendations for selecting autolytic debridement in the treatment of diabetic foot ulcers. Recommendations for selecting surgical, mechanical, larvae, conservative sharp wound debridement, and enzymatic debridement techniques were also identified. Two guidelines also recommended callus debridement for treatment and prevention of DFU without recommending a specific debridement technique.

Project Status: Completed

Year Published: 2014

URL for published report: http://www.cadth.ca/media/pdf/htis/dec-2014/RC0579-002%20Diabetic%20Foot%20Ulcers%20Final.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Agency for Drugs and Technologies in Health

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)