M Monami1, A Scatena2, S Zannoni3, S Aleffi3, C Mirabella4, L Giannoni3, E Mannucci3. 1. Diabetic Foot Unit, SOD Diabetologia-Azienda Ospedaliero Universitaria Careggi, Via delle Oblate n. 4, 50141, Florence, Italy. matteo.monami@unifi.it. 2. Diabetology Unit, San Donato Hospital, Arezzo, Italy. 3. Diabetic Foot Unit, SOD Diabetologia-Azienda Ospedaliero Universitaria Careggi, Via delle Oblate n. 4, 50141, Florence, Italy. 4. Department of Immunohematology and Transfusion Medicine, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
Abstract
AIM: Debridement of fibrin and necrotic tissue from the ulcer surface is an important component of the treatment of diabetic ulcers. A possible alternative to standard lancets is represented by CO2 laser, which vaporizes necrotic tissues together with any pathogen. The present trial is aimed at verifying the effect of a CO2 laser on bacterial load in the debridement of infected diabetic foot ulcers. METHODS: In this open-label randomized controlled trial (NCT02677779), patients with diabetes and an infected foot ulcers were randomized to either CO2 laser or traditional debridement. RESULTS: The reduction (%) of bacterial load with CO2 laser was significantly greater than in control group [-99.9 (-100.0; -90.0) vs. -50.0 (-96.0; -75.0), p = 0.049]. Similarly, a significantly greater reduction (%) of the fraction of ulcer area covered by fibrin was obtained in the intervention group [-84.1 (-95.0; -72.2) vs. -46.9 (-69.5; -40.8), p = 0.038]. CONCLUSIONS: Debridement of ulcers with CO2 laser significantly reduces bacterial load and fibrin-covered areas, and could be of help in the treatment of diabetic foot ulcer.
RCT Entities:
AIM: Debridement of fibrin and necrotic tissue from the ulcer surface is an important component of the treatment of diabetic ulcers. A possible alternative to standard lancets is represented by CO2 laser, which vaporizes necrotic tissues together with any pathogen. The present trial is aimed at verifying the effect of a CO2 laser on bacterial load in the debridement of infected diabetic foot ulcers. METHODS: In this open-label randomized controlled trial (NCT02677779), patients with diabetes and an infected foot ulcers were randomized to either CO2 laser or traditional debridement. RESULTS: The reduction (%) of bacterial load with CO2 laser was significantly greater than in control group [-99.9 (-100.0; -90.0) vs. -50.0 (-96.0; -75.0), p = 0.049]. Similarly, a significantly greater reduction (%) of the fraction of ulcer area covered by fibrin was obtained in the intervention group [-84.1 (-95.0; -72.2) vs. -46.9 (-69.5; -40.8), p = 0.038]. CONCLUSIONS: Debridement of ulcers with CO2 laser significantly reduces bacterial load and fibrin-covered areas, and could be of help in the treatment of diabetic foot ulcer.
Entities:
Keywords:
CO2 laser; Foot ulcer; Randomized trial; Type 2 diabetes
Authors: M Monami; C Mirabella; A Scatena; B Nreu; S Zannoni; S Aleffi; L Giannoni; E Mannucci Journal: J Endocrinol Invest Date: 2017-03-04 Impact factor: 4.256