Hydrogel may be effective for healing diabetic foot ulcers

Clinical question: 
How effective are debridement interventions on the healing of diabetic foot ulcers?
Bottom line: 
Compared with gauze dressings or standard care, hydrogel increased the healing rate of diabetic foot ulcers. However, since hydrogel functions by increasing the moisture of the wound environment, it was not clear whether this effect was mediated through debridement per se. There was insufficient evidence (1 small trial, abstract only) of the effects of larval therapy on diabetic foot ulcers, but it did seem to reduce wound area. Surgical debridement showed no significant benefit over standard treatment.
Caveat: 
In general, the studies were small and of poor methodological quality, resulting in a high risk of bias. There was a diversity of debridement interventions, and no replicating studies. Other debridement methods, such as enzyme preparations or polysaccharide beads, have not been evaluated in the treatment of diabetic foot ulcers.
Context: 
Foot ulceration is thought to affect 15% of people with diabetes at some time in their lives. Debridement is widely regarded as an effective intervention to speed up ulcer healing. The most effective method is unclear.
Review CD#: 
CD003556
PEARLS No: 
354
Date: 
March, 2012
Authored by: 
Brian R McAvoy