Background: Diabetic patients are susceptible to developing
foot ulcers with serious complications such as
osteomyelitis and
amputations. Treatment approaches are still empirical and the benefit of usual procedures such as surgical
debridement has not been properly evaluated.
Photodynamic Therapy (
PDT) is a non-invasive and highly efficient method for the treatment of the
diabetic foot, being able to eradicate the
infection and to stimulate healing, decreasing considerably the
amputation risk. In the day-to-day practice of our service, we have been faced with the question whether
debridement is necessary before
PDT. In here, we designed a study to answer that question. Methods: Patients were divided in two groups: In one of the groups (n = 17),
debridement was performed before
PDT and in the other (n = 40) only
PDT treatment was performed.
PDT sessions were performed once a week in all patients until healing was achieved, as indicated by visual inspection as well as by radiographic and laboratory exams. At the start of the study, the two groups had no statistical differences concerning their clinical features: average age, gender,
insulin use,
diabetes mellitus onset time and previous
amputations. Results:
PDT was effective in the treatment of 100% of the patients showing no relapses after one year of follow up. The group submitted to
PDT without previous
debridement had a statistically significant (p = 0.036, Mann-Whitney) shorter cure time (29 days, ~27%). Conclusion: Our data indicates that
debridement is not necessary in the treatment of
diabetic foot in patients that have enough peripheral arterial perfusion. In addition, we reproduced previous studies confirming that
PDT is an efficient, safe, simple and affordable treatment method for the
diabetic foot.