Royal Prince Alfred Hospital Department of Podiatry, Sydney Local Health District, Australia.
Sydney Medical School (Central), Faculty of Medicine and Health, The University of Sydney, Australia.
J Wound Care. 2023 Jun 2;32(6):383-390. doi: 10.12968/jowc.2023.32.6.383.
Diabetic foot ulcers (DFU) are a serious and costly long-term complication of diabetes, and are one of the most prevalent hard-to-heal (chronic) wound types. Conservative sharp wound debridement (CSWD) is a mainstay of care. It is performed regularly until healing is achieved (when there is adequate blood flow for healing) to support endogenous healing and improve the efficacy of advanced healing therapies. CSWD is supported by evidence-based treatment guidelines, despite a lack of prospective studies. The first prospective randomised study to compare different frequencies of CSWD-the Diabetes Debridement Study (DDS)-showed no difference in healing outcomes at 12 weeks between those ulcers debrided weekly and those debrided every second week. A DFU may require more or less frequent debridement according to individual wound characteristics; however, the new data from DDS can inform clinical decisions and service provision. The implications of weekly versus second-weekly debridement are discussed.
糖尿病足溃疡（DFU）是糖尿病的一种严重且代价高昂的长期并发症，也是最常见的难以愈合（慢性）伤口类型之一。保守性锐器清创术（CSWD）是主要的治疗方法。它定期进行，直到愈合（有足够的血液流动以进行愈合），以支持内源性愈合并提高先进愈合疗法的疗效。尽管缺乏前瞻性研究，但 CSWD 得到了循证治疗指南的支持。第一项比较不同 CSWD 频率的前瞻性随机研究——糖尿病清创研究（DDS）——显示每周清创和每两周清创的溃疡在 12 周时的愈合结果没有差异。根据个体伤口特征，DFU 可能需要更频繁或更少频率的清创；然而，DDS 的新数据可以为临床决策和服务提供提供信息。讨论了每周与每两周清创的影响。
