Low-Frequency Contact Ultrasonic Debridement in Diabetic Foot Ulcer

Abstract

Diabetic foot ulcers (DFUs) are important causes of morbidity and mortality in people with diabetes mellitus (DM). Between 19 and 34% of patients with DM will develop a DFU in their lifetime. If not treated correctly, these wounds can result in complications such as infection, amputation, and the death of the patient. A fundamental part of local wound care is debridement, which consists of removing non-viable tissue from the wound bed in order to obtain healthy tissue to promote healing. An alternative to traditional debridement techniques (sharp, enzymatic, autolytic, and biological debridement) is low-frequency ultrasonic debridement (LFUD). The effectiveness of LFUD is based on the non-thermal effects of cavitation and micro-streaming, which generate a series of clinical effects on the wound bed: debridement effect, wound healing stimulant effect, and bactericidal effect. Several recent studies have demonstrated a positive effect of LFUD with higher healing rates, shorter healing times, greater percentages of wound area reduction, and a significant reduction in bacterial load in DFUs. This chapter aims to give an overview of this type of recent mechanical debridement in the treatment of patients with DFUs.