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

Table 3 Choice of wound care materials for healing/sinus or cavity wounds

Wound classification	Choice of wound care materials	Advantages	Disadvantages
Granulating wounds	Non adherent dressing	Reduces trauma to the healing tissue Maintains a moist wound healing environment	Chance of shearing to new epithelium
	Wet to dry dressing	Promotes healing	Chance of bleeding if not soaked with saline before dressing change
	Polyurethane foam	Maintains a moist wound healing environment Promotes healing process	Chance of bleeding if not soaked before dressing change
	Topical antibacterial such as metronidazole, mupirocin, Tulle, Silver containing ointments, Acetic acid 0.5%-5% and povidone iodine	Maintains a moist wound healing environment, promotes epithelization and controls odor Effective against Gram positive cocci including MRSA. Silver sulfadiazine has broad antibacterial coverage, accelerates epithelization, and is very effective in burns. Acetic acid is very effective against Pseudomonas. Povidone iodine is very effective for gangrene as it hastens demarcation	Silver containing ointments cannot be used in Sulfa allergy patients Povidone iodine is cytotoxic to fibroblasts and delays the healing process
	Platelet derived growth factor	Faster healing and very effective	Expensive
	Hydrogel	Promotes healing	Chance of maceration and is expensive
	Hydrocolloid	Promotes healing Reduces the interval of dressing change	Chance of maceration and is expensive
Epithelizing wounds	Non adherent	Reduces trauma to the healing tissue Maintains a moist wound healing environment	Chances of shearing
	Wet to dry dressing	Promotes faster healing	Soaking of dressing is required prior to dressing change
	Topical antibacterial	As mentioned in granulating wounds	As mentioned in granulating wounds
	Epidermal growth factor	Effective and faster healing	Expensive
	Hydrogel	Effective	Chance of maceration and is expensive
	Hydrocolloid	Effective	Chance of maceration and is expensive
Cavity/Sinus wounds	Alginate	Highly absorbent and non-adherent Maintains a moist wound healing environment	Needs adequate padding and is expensive
	Hydrogel	Effective in promoting granulation tissue	Needs adequate padding and is expensive