Impact on Wound Healing and Efficacy of Various Leg Ulcer Debridement Techniques

J Dtsch Dermatol Ges. 2012 Sep;10(9):624-32. doi: 10.1111/j.1610-0387.2012.07952.x. Epub 2012 May 16.
[Article in English, German]

Abstract

Aim: To evaluate the evidence on the impact of different debridement techniques on healing and their efficacy in the treatment of leg ulcers.

Methods: Web-based search (PubMed) for trials investigating surgical, enzymatic, autolytic, osmotic, ultrasound-assisted, and biosurgical wound debridement on leg ulcers with regard to healing and efficacy.

Results: Both surgical and hydrosurgical methods proved to be effective debridement techniques. For conventional surgical debridement, a significantly greater reduction of the wound surface area and a higher healing rate were reported. Studies on autolytic, osmotic, and enzymatic wound debridement showed effective debridement for krill enzymes, dextranomer and manuka honey. Only for manuka honey was there a significantly greater reduction of the wound surface area compared to standard treatment. One study comparing fibrinolysin/DNAse with placebo and one comparing autolytic with enzymatic debridement showed no significant differences between the respective techniques. Trials on ultrasound-assisted wound debridement reported a positive impact on healing. A significant wound surface area reduction was demonstrated in one of them. Maggot therapy led to effective debridement. The largest trial showed no significantly improved healing.

Conclusions: Further studies are needed to strengthen the evidence for a significant impact of wound debridement on the healing of leg ulcers.

Publication types

  • Editorial
  • Meta-Analysis
  • Review

MeSH terms

  • Debridement / statistics & numerical data*
  • Dermatologic Surgical Procedures / statistics & numerical data*
  • Humans
  • Leg Ulcer / epidemiology*
  • Leg Ulcer / surgery*
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control
  • Prevalence
  • Treatment Outcome
  • Wound Healing*