Comparative analysis of surgical and non‐surgical wound approaches in diabetic foot ulcer treatment: Meta‐analysis and systematic review

Abstract

AbstractThe assessment for safety and effectiveness of surgical interventions in the management of diabetic foot ulcers (DFUs) in comparison to non‐surgical approaches was performed. A comprehensive search was performed across PubMed, MEDLINE, Cochrane Library and EMBASE in order to identify case–control studies, randomized controlled trials (RCTs), observational studies, cohort studies and observational studies pertaining to DFU treatments. Studies conducted in English language and focusing on wound healing rates, recurrence rates, time to healing and complication management met the inclusion criteria. There were six studies included in this meta‐analysis. Surgical procedures, such as debridement, revascularization and skin transplantation, demonstrated significantly superior efficacy in promoting wound healing (84%) and shorter duration of healing (6 weeks) in comparison to non‐surgical approaches, including off‐loading, wound dressings and pharmacological therapies. Surgical interventions for DFUs resulted in a wound recovery rate of 84%, a significantly higher mean rate than non‐surgical approaches (60%) that was observed. In addition, it was observed that the surgical group experienced considerably reduced average healing period of 9 weeks, in contrast to the non‐surgical group's mean healing period of 12 weeks. Nevertheless, it is imperative to acknowledge that surgical procedures were notably correlated with a heightened occurrence of complications, such as amputations, which transpired in 19% of instances. Surgical interventions for DFUs may provide superior short‐term results with regard to healing rates and recovery time, as indicated by this meta‐analysis. However, they are additionally correlated with the heightened likelihood of complications. Although non‐surgical techniques offered comparatively secure option, they were also less reliable. Individualized treatment modalities should be chosen in consideration of patient‐specific factors and comparative advantages and disadvantages.