Choice of wound care in diabetic foot ulcer: A practical approach

Table 2 Choice of wound care materials for necrotic and sloughy wounds

Wound classification	Choice of wound care material	Advantages	Disadvantages
Necrotic wound	Wet to dry	Good debriding capacity and inexpensive	Frequent dressing change Painful if not soaked with saline prior to dressing change
	Topical antibacterial such as metronidazole	Very good antibacterial coverage Maintains a moist wound healing environment by promoting autolysis and controls odor	Chance of maceration Contraindicated in infected necrotic wounds
	Hydrogel	Hydrates the wound by promoting autolysis	Chance of maceration Contraindicated in infected necrotic wounds and is expensive
	Hydrocolloid	Maintains a moist wound healing environment, which helps in autolytic debridement	Expensive Contraindicated in infected necrotic wounds
Sloughy wound	Wet to dry	Good debriding capacity Absorptive, adhesive and cheapest	Frequent dressing change Painful if not soaked with saline prior to dressing change
	Topical enzymes such as collagenase, papain, fibrinolysis	Promotes autolytic debridement by desloughing Can be used in combination with metronidazole or hydrogel	Contraindicated in granulating or epithelizing wounds
	Topical antibiotics such as metronidazole	Very good antibacterial coverage Maintains moist wound healing environment by promoting autolysis and controls odor	Chance of maceration
	Polyurethane Foam	Very effective in desloughing Maintains a moist wound healing environment by promoting granulation	Sometimes painful if not soaked with saline prior to dressing change
	Hydrogel	Hydrates the wound by promoting autolysis	Chance of maceration and is expensive
	Hydrocolloid	Maintains a moist wound environment, which helps in autolytic debridement	Chance of maceration and is expensive