Which dressing for diabetic foot ulcers?

Abstract

A wide variety of different dressings are used on diabetic foot ulcers and it is difficult to know how the choice of dressings is made. A questionnaire was sent to 250 diabetes specialist nurses and 249 state registered chiropodists in different parts of the United Kingdom and Ireland asking which dressings they would use on various categories of ulcer in a person with diabetes. A total of 192 questionnaires (38.5%) were returned, of which 188 (37.7%) were complete. There was no consensus at all on the choice of dressings in any ulcer category and, for most types of ulcer, between five and eight dressing types were used by respondents. In no category did a dressing achieve more than a 30% preference rating. Respondents also varied widely in their use of other types of ulcer treatment such as low-power laser therapy. The findings suggest that either there is a great deal of ignorance about the best dressing to use, or it does not matter which dressing is used. As dressings vary widely in cost, it is likely that the best policy is to use the safest, simplest and cheapest dressing.