Abstract：
BACKGROUND: Diabetic foot ulcers (DFUs) are commonly contaminated with pathogenic organisms and precede most diabetes-related amputations. Antimicrobial dressings are used in the treatment of DFUs; however, recent guidelines do not support their use. There are no data describing the experience of antimicrobial dressing use among podiatrists in Aotearoa New Zealand (AoNZ). This study aimed to (i) determine which antimicrobial dressings podiatrists in AoNZ use for the management of diabetic foot ulcers; and (ii) determine what factors influence AoNZ podiatrists\' use of antimicrobial dressing when managing DFUs.
METHODS: An anonymous cross-sectional web-based survey was undertaken. Participants were AoNZ registered podiatrists who managed DFUs in their practice. The survey included questions relating to personal and professional demographic characteristics and DFU management and dressing practices. Descriptive statistics were computed to address the research aims.
RESULTS: Responses from 43 AoNZ podiatrists were included. Participants reported both cadexomer iodine and silver dressings were the most common antimicrobial dressings used, with honey dressings being the least frequently used. The most influential factors in choosing antimicrobial dressings when managing DFUs were the presence of current infection, ulcer exudate and ability to prevent future infection. The least influential factors in choosing antimicrobial dressings when managing DFUs were patient preferences, cost of dressings and comfort of dressing/pain on removal.
CONCLUSIONS: AoNZ podiatrists managing DFUs primarily use antimicrobial dressings containing cadexomer iodine or silver as active ingredients, while lower-cost options, such as honey and povidone iodine are less often used. Current recommendations highlight the lack of evidence to support positive outcomes from any particular antimicrobial dressing over another and advocate that exudate control, comfort and cost be prioritised in decision-making. As cost has been an increasing burden to our healthcare funding, clinicians and organisations may consider this before purchasing and stocking expensive dressings.
METHODS: An anonymous cross-sectional web-based survey was undertaken. Participants were AoNZ registered podiatrists who managed DFUs in their practice. The survey included questions relating to personal and professional demographic characteristics and DFU management and dressing practices. Descriptive statistics were computed to address the research aims.
RESULTS: Responses from 43 AoNZ podiatrists were included. Participants reported both cadexomer iodine and silver dressings were the most common antimicrobial dressings used, with honey dressings being the least frequently used. The most influential factors in choosing antimicrobial dressings when managing DFUs were the presence of current infection, ulcer exudate and ability to prevent future infection. The least influential factors in choosing antimicrobial dressings when managing DFUs were patient preferences, cost of dressings and comfort of dressing/pain on removal.
CONCLUSIONS: AoNZ podiatrists managing DFUs primarily use antimicrobial dressings containing cadexomer iodine or silver as active ingredients, while lower-cost options, such as honey and povidone iodine are less often used. Current recommendations highlight the lack of evidence to support positive outcomes from any particular antimicrobial dressing over another and advocate that exudate control, comfort and cost be prioritised in decision-making. As cost has been an increasing burden to our healthcare funding, clinicians and organisations may consider this before purchasing and stocking expensive dressings.
摘要：
背景：糖尿病足溃疡（DFU）通常被病原微生物污染，并在大多数糖尿病相关截肢之前发生。抗微生物敷料用于治疗DFU；然而，最近的指南不支持它们的使用。没有数据描述了Aotearoa新西兰（AoNZ）足病医生使用抗菌敷料的经验。这项研究旨在（i）确定AoNZ足病医生使用哪种抗菌敷料来管理糖尿病足溃疡；（ii）确定哪些因素会影响AoNZ足病医生在管理DFU时使用抗菌敷料。
方法：进行了基于网络的匿名横断面调查。参与者是AoNZ注册的足病医生，他们在实践中管理DFU。调查包括与个人和专业人口统计学特征以及DFU管理和穿衣实践有关的问题。计算描述性统计数据以实现研究目标。
结果：纳入了43名AoNZ足病医生的反应。参与者报告说，cadexomer碘和银敷料是最常用的抗菌敷料，蜂蜜敷料是最不常用的。在管理DFU时选择抗菌敷料的最有影响的因素是当前感染的存在，溃疡渗出物和预防未来感染的能力。在管理DFU时选择抗菌敷料的影响最小的因素是患者的偏好，敷料的成本和敷料的舒适性/去除疼痛。
结论：管理DFU的AoNZ足病医生主要使用含有cadexomer碘或银作为活性成分的抗菌敷料，虽然成本较低的选择，例如蜂蜜和聚维酮碘较少使用。目前的建议强调缺乏证据支持任何特定抗菌敷料的积极结果，并主张控制渗出物，在决策中优先考虑舒适性和成本。由于成本一直是我们医疗保健资金的负担，临床医生和组织在购买和储备昂贵的敷料之前可能会考虑这一点。
方法：进行了基于网络的匿名横断面调查。参与者是AoNZ注册的足病医生，他们在实践中管理DFU。调查包括与个人和专业人口统计学特征以及DFU管理和穿衣实践有关的问题。计算描述性统计数据以实现研究目标。
结果：纳入了43名AoNZ足病医生的反应。参与者报告说，cadexomer碘和银敷料是最常用的抗菌敷料，蜂蜜敷料是最不常用的。在管理DFU时选择抗菌敷料的最有影响的因素是当前感染的存在，溃疡渗出物和预防未来感染的能力。在管理DFU时选择抗菌敷料的影响最小的因素是患者的偏好，敷料的成本和敷料的舒适性/去除疼痛。
结论：管理DFU的AoNZ足病医生主要使用含有cadexomer碘或银作为活性成分的抗菌敷料，虽然成本较低的选择，例如蜂蜜和聚维酮碘较少使用。目前的建议强调缺乏证据支持任何特定抗菌敷料的积极结果，并主张控制渗出物，在决策中优先考虑舒适性和成本。由于成本一直是我们医疗保健资金的负担，临床医生和组织在购买和储备昂贵的敷料之前可能会考虑这一点。
