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Open AccessArticle

Cellular Proliferation, Dermal Repair, and Microbiological Effectiveness of Ultrasound-Assisted Wound Debridement (UAW) Versus Standard Wound Treatment in Complicated Diabetic Foot Ulcers (DFU): An Open-Label Randomized Controlled Trial

1
Diabetic Foot Unit, Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28040 Madrid, Spain
2
Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
3
Microbiology Section, Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(12), 4032; https://doi.org/10.3390/jcm9124032
Received: 29 October 2020 / Revised: 1 December 2020 / Accepted: 10 December 2020 / Published: 13 December 2020
We aimed to evaluate the effects of ultrasound-assisted wound (UAW) debridement on cellular proliferation and dermal repair in complicated diabetic foot ulcers as compared to diabetic foot ulcers receiving surgical/sharp wound debridement. A randomized controlled trial was performed involving 51 outpatients with complicated diabetic foot ulcers that either received surgical debridement (n = 24) or UAW debridement (n = 27) every week during a six-week treatment period. Compared to patients receiving surgical debridement, patients treated with UAW debridement exhibited significantly improved cellular proliferation, as determined by CD31 staining, Masson’s trichrome staining, and actin staining. Bacterial loads were significantly reduced in the UAW debridement group compared to the surgical group (UAW group 4.27 ± 0.37 day 0 to 2.11 ± 0.8 versus surgical group 4.66 ± 1.21 day 0 to 4.39 ± 1.24 day 42; p = 0.01). Time to healing was also significantly lower (p = 0.04) in the UAW group (9.7 ± 3.8 weeks) compared to the surgical group (14.8 ± 12.3 weeks), but both groups had similar rates of patients that were healed after six months of follow-up (23 patients (85.1%) in the UAW group vs. 20 patients (83.3%) in the surgical group; p = 0.856). We propose that UAW debridement could be an effective alternative when surgical debridement is not available or is contraindicated for use on patients with complicated diabetic foot ulcers. View Full-Text
Keywords: ultrasound assisted wound debridement; surgical debridement; cellular proliferation; microbiology; diabetic foot ulcers ultrasound assisted wound debridement; surgical debridement; cellular proliferation; microbiology; diabetic foot ulcers
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MDPI and ACS Style

Lázaro-Martínez, J.L.; Álvaro-Afonso, F.J.; Sevillano-Fernández, D.; García-Álvarez, Y.; Sanz-Corbalan, I.; García-Morales, E. Cellular Proliferation, Dermal Repair, and Microbiological Effectiveness of Ultrasound-Assisted Wound Debridement (UAW) Versus Standard Wound Treatment in Complicated Diabetic Foot Ulcers (DFU): An Open-Label Randomized Controlled Trial. J. Clin. Med. 2020, 9, 4032. https://doi.org/10.3390/jcm9124032

AMA Style

Lázaro-Martínez JL, Álvaro-Afonso FJ, Sevillano-Fernández D, García-Álvarez Y, Sanz-Corbalan I, García-Morales E. Cellular Proliferation, Dermal Repair, and Microbiological Effectiveness of Ultrasound-Assisted Wound Debridement (UAW) Versus Standard Wound Treatment in Complicated Diabetic Foot Ulcers (DFU): An Open-Label Randomized Controlled Trial. Journal of Clinical Medicine. 2020; 9(12):4032. https://doi.org/10.3390/jcm9124032

Chicago/Turabian Style

Lázaro-Martínez, José L.; Álvaro-Afonso, Francisco J.; Sevillano-Fernández, David; García-Álvarez, Yolanda; Sanz-Corbalan, Irene; García-Morales, Esther. 2020. "Cellular Proliferation, Dermal Repair, and Microbiological Effectiveness of Ultrasound-Assisted Wound Debridement (UAW) Versus Standard Wound Treatment in Complicated Diabetic Foot Ulcers (DFU): An Open-Label Randomized Controlled Trial" J. Clin. Med. 9, no. 12: 4032. https://doi.org/10.3390/jcm9124032

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