2026-06-07T15:51:41Zhttps://docta.ucm.es/rest/oai/request
oai:docta.ucm.es:20.500.14352/1098572025-03-18T12:56:47Zcom_20.500.14352_14col_20.500.14352_15
Docta Complutense author Lázaro Martínez, José Luis author Álvaro Afonso, Francisco Javier author García Álvarez, Yolanda author Molines Barroso, Raúl Juan author García Morales, Esther Alicia author Sevillano Fernández, David 2024-10-31T13:03:19Z 2024-10-31T13:03:19Z 2018-05-08 Lázaro-Martínez JL, Álvaro-Afonso FJ, García-Álvarez Y, Molines-Barroso RJ, García-Morales E, Sevillano-Fernández D. Ultrasound-assisted debridement of neuroischaemic diabetic foot ulcers, clinical and microbiological effects: a case series. J Wound Care. 2018 May 2;27(5):278-286. 0969-07002052-2916 10.12968/jowc.2018.27.5.278 https://hdl.handle.net/20.500.14352/109857 https://doi.org/10.12968/jowc.2018.27.5.278 https://www.magonlinelibrary.com/doi/abs/10.12968/jowc.2018.27.5.278 Objective: To evaluate the clinical and microbiological effects of sequential wound debridement in a case series of neuroischaemic diabetic foot ulcers (DFUs) using an ultrasound-assisted wound debridement (UAW) device. Method: A prospective, single-centre study, involving a case series of 24 neuroischaemic DFUs, was conducted to evaluate sequential wound debridement with UAW during a six-week treatment period. Soft tissue punch biopsies were taken every second week of treatment, both before and after wound debridement sessions. Qualitative and quantitative microbiological analysis was performed and wounds were assessed at patient admission, and before and after each debridement procedure. Results: Wound tissue quality scores improved significantly from a mean score of 2.1±1.3 points at patient inclusion, to 5.3±1.7 points (p=0.001). Mean wound sizes were 4.45cm2 (range: 2–12.25cm2) at week zero, and 2.75cm2 (range: 1.67–10.70cm2) at week six (p=0.04). The mean number of bacterial species per culture determined at week zero and at week six was 2.53±1.55 and 1.90±1.16, respectively (p=0.023). Wound debridement resulted in significant decreases in bacterial counts (1.17, 1.31 and 0.77 log units in colony forming units (CFU) for week zero, three and six, respectively). The average bacterial load in tissue samples before and after wound debridement after the six-week treatment was Log 5.55±0.91CFU/g and Log 4.59±0.89CFU/g, respectively (p<0.001). Conclusions: The study results showed a significant bacterial load reduction in DFU tissue samples as a result of UAW debridement, independent of bacterial species, some of which exhibited antibiotic-resistance. Significant bacterial load reduction was correlated with improved wound conditions and significant reductions of wound size. eng Ultrasound-assisted debridement of neuroischaemic diabetic foot ulcers, clinical and microbiological effects: a case series journal article 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 URL https://docta.ucm.es/bitstreams/c5161ffd-2dd5-4201-ac31-8afc84199cfb/download File MD5 f70d9b7c67b14c0e565da923d6430303 698082 application/pdf Ultrasound_assisted_debridement.pdf URL https://docta.ucm.es/bitstreams/27405b41-c3dc-4ed2-b553-6369276dc2b5/download File MD5 7903c50bbec53ebce4e30cedeefc7bc7 37440 text/plain Ultrasound_assisted_debridement.pdf.txt