Clinical Effects of Weekly and Biweekly Low-Frequency Ultrasound Debridement Versus Standard of Wound Care in Patients with Diabetic Foot Ulcers: A Pilot Randomized Clinical Trial.

In 30 seconds

This pilot randomized clinical trial compared weekly or biweekly low-frequency ultrasound debridement with standard wound care in 30 patients with diabetic foot ulcers over a 12-week treatment period. At 6 months, healing rates were 70% with weekly ultrasound, 54.4% with biweekly ultrasound, and 33.3% with standard care (P = .27). Weekly ultrasound was associated with shorter healing time, greater wound-area reduction, and higher Wollina wound scores than the other groups. The small trial did not demonstrate a statistically significant difference in healing rates.

Key findings

• Six-month healing rates were 70% with weekly ultrasound, 54.4% with biweekly ultrasound, and 33.3% with standard care (P = .27).
• Median healing time was 11 (IQR 7-19) weeks with weekly ultrasound, 18 (IQR 15-36) weeks with standard care, and 24.5 (IQR 16-30) weeks with biweekly ultrasound (P = .036).
• Wound area reduction was 87.5 ± 18.5% with weekly ultrasound, 68.6 ± 26.2% with biweekly ultrasound, and 38.9 ± 16.6% with standard care (P = .014).
• Wollina wound scores were higher in both ultrasound groups than standard care: 7 (IQR 6-7), 7 (IQR 6.5-7), and 4 (IQR 3-6), respectively (P = .002).

Why it matters

Diabetic foot ulcer healing can be prolonged, and this trial suggests that the frequency of ultrasound debridement may matter: weekly treatment was associated with faster healing and greater wound-area reduction than biweekly treatment or standard care. The findings add comparative evidence for an alternative debridement approach, while the nonsignificant difference in healing rates means the apparent benefits should be interpreted cautiously.

What to keep in mind

This was a pilot trial with only 30 participants, and the difference in healing rates was not statistically significant.