Evidence Corner: September 2006

Laura L. Bolton, PhD, FAPWCA

Disclosures

Wounds. 2006;18(9):A19,A20-A22. 

In This Article

Dear Readers

To heal a chronic wound, one diagnoses and alleviates the cause of tissue damage then debrides necrotic tissue and provides an appropriately moist environment for healing.[1] Without effective debridement, necrotic tissue may impede healing[2] or act as a foreign body or a focus for microbial proliferation. Clarity is emerging on clinical efficacy of debriding modalities for chronic wounds. For example, a systematic review of debridement efficacy reported that hydrogels are the only debridement category with randomized, controlled trial evidence of faster diabetic foot ulcer healing as compared to gauze.[3] More recent research reported that surgical debridement of slough or necrotic tissue from recalcitrant venous leg ulcers hastened healing 4 or 20 weeks after curettage compared to recalcitrant venous ulcers without slough.[4] Readers have requested perspective on the best chronic wound evidence available on maggot therapy or “larval debridement” to aid their clinical decision making. Special thanks go to Dr. Sherman, author of the 2 studies summarized here, who provided me with the best available maggot therapy evidence to supplement the MEDLINE search that was conducted for this column.

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