Effectiveness of ultrasound debridement of wounds in diabetic foot syndrome patients

Abstract

We aimed to evaluate the effectiveness of ultrasound debridement of diabetic foot ulcers without active infection in presence of the critical ischemia, which was  assessed as low transcutaneous oxygen pressure (PtcO2) measured on the foot. The study involved 69 patients with PEDIS scores Р3, D1-2, I1, S1. All participants  received the usual therapy of diabetes mellitus. 27 of them were included to study group (SG) and received 3-4 ultrasound procedures by the person. The rest 27 were  included to control group (CG). Statistical analysis on days 7th and 28th has not revealed significant differences between groups. Instead we obtained  interesting data after the analysis in subgroups divided by the PtcO2 levels. In PtcO2<20 mm Hg the relative speed of healing (RSH) was 11,15±13,77% for 4 weeks in SG vs. 8,83±5,58% in CG (p<0,05). Slight healing can only be achieved on a background of drug revascularization. Nine patients of SG and 7 patients of CG were  undergone amputation at the thigh or shin in terms of 1-7 months after treatment. Simultaneously in patients with PtcO 2 levels ranged from 20 to 29 mm Hg the  difference in the RSH between the SG and CG was statistically significant: 45,27±11,35% vs. 28,02 ± 8,80% for 4 weeks (p<0,01). So, we concluded that adequate revascularization is ultimately needed to provide healing of diabetic foot ulcers under ultrasound debridement.