Review: debridement using hydrogel appears to be more effective than standard wound care for healing diabetic foot ulcers.

Main results 5 RCTs met the selection criteria. 3 trials compared hydrogel as a method of debridement with standard wound care (good wound care or gauze). 1 trial compared hydrogel with larval therapy. 1 trial compared surgical debridement with conservative care. In all 5 trials, the primary outcome was complete wound closure. Sample sizes ranged from 29 to 172 patients. In 4 studies, follow up durations ranged from 3 to 6 months. Meta-analysis of 3 studies showed that hydrogel was associated with a greater proportion of ulcers completely healed and fewer complications than standard wound care (table). In 1 study, larvae and hydrogel did not differ for proportion of ulcers completely healed (7% v 3%, follow up duration not reported). In 1 trial, surgical debridement and conservative care did not differ for proportion of ulcers completely healed (95% v 79%, p=0.1), recurrence rates (14% v 33%, p=0.14), or complication rates (5% v 13%, p=0.4) at 6 months.