Chlorhexidine vs Routine Foot Washing to Prevent Diabetic Foot Ulcers

作者：Alison D. Lydecker, Justin Kim, Gwen Robinson, J. Kristie Johnson, Clayton H. Brown, Christopher C. Petruccelli, Michael L. Terrin, David J. Margolis, Mary‐Claire Roghmann · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2024.60087 · 被引用次数：8 · 研究领域：Diabetic Foot Ulcer Assessment and Management、Wound Healing and Treatments、Peripheral Artery Disease Management

Importance: Foot ulcers are a common and feared complication for people with diabetes because 20% of foot ulcers become infected and lead to a lower extremity amputation. Objective: To evaluate the effect of daily foot care using chlorhexidine wipes vs soap-and-water wipes for 1 year on the risk of developing new foot complications in veterans with diabetes. Design, Setting, and Participants: This double-blind, placebo-controlled, phase 2b randomized clinical trial was conducted at the Baltimore Veterans Affairs (VA) Medical Center between January 2019 to January 2023. Veterans were eligible if they had a diabetes diagnosis, were at high risk for diabetic foot complications, were ambulatory, had both feet, and did not have a current foot infection. Participants were randomly assigned 1:1 to receive either soap-and-water wipes (control group) or 2% chlorhexidine wipes (chlorhexidine group). Intention-to-treat data analysis was conducted from October 5, 2023, to April 24, 2024. Intervention: Daily use of a 2% chlorhexidine wipe or a soap-and-water wipe on the feet for 1 year. Wipes were nearly identical in color, size, shape, thickness, feel, and scent. Both chlorhexidine and control groups received the same lotion for application on the feet after wipe use and education on foot self-care. Main Outcomes and Measures: The primary outcome was time in days from randomization to new foot complication, including chronic foot ulcer, foot infection, or foot amputation. Results: A tota...