Low-frequency ultrasound debridement in patients with diabetic foot ulcers and osteomyelitis.

BACKGROUND Although debridement plays a significant role in the healing of diabetic foot ulcers, it may delay the healing process by damaging the granulation tissue. In this study, the efficacy of low-frequency ultrasound (LFU) in chronic wound healing in diabetic foot ulcers in patients with osteomyelitis was evaluated. METHODS This randomized clinical trial was conducted on 40 patients with diabetes recruited from the Diabetic Foot Ulcer Clinic of the Endocrinology and Metabolism Research Center of Tehran University of Medical Sciences, Tehran, Iran. All patients with a grade 3 ulcer (Wagner Classification) with 0.6 ≤ ankle brachial index ≤ 1.2, were included. Patients were divided into 2 groups; 1 group received ultrasound-assisted wound therapy (UAW) in conjunction with standard wound care (n = 20) and the control group received only standard wound care. Patients were followed for 6 months. RESULTS The complete healing rate in the study population was 55.7% (control group = 55%, UAW group = 60%). The mean wound size reduction percentage was significantly higher in the UAW group only in the second month (78% ± 28.7 vs 55.7% ± 31.4, P = 0.01) and third month (63.6% ± 24.5 vs 39.3% ± 32.2 , P = 0.02) of follow up, but not at 6 months. CONCLUSION In grade 3 diabetic foot ulcers, LFU debridement accompanied by standard wound care can initially accelerate ulcer healing; however, there is no significant difference between the 2 modalities in the healing rate after 6 months. .