Table 1 Participant inclusion and exclusion criteria

General:

≥ 30 years of age

Able to provide informed consent

Ulcers present for ≥ 1 month

Ulcers ≥ 1 cm²

General:

Patients taking immunosuppressive medications

Known allergy to ulcer dressing products

Pre-existing ulcer pain preventing either type of debridement

Vascular:

Palpable pedal pulses OR toe pressure ≥ 45 mmHg OR those meeting Rutherford Classification of peripheral arterial disease stages [13]:

0 (Asymptomatic)

1 (Mild claudication)

2 (Moderation claudication at 200 m)

Vascular:

Those meeting Rutherford Classification of peripheral arterial disease stages:

3 (Severe claudication)

4 (Rest pain)

5 (Ischaemic ulceration no exceeding ulcer of the digits of the toes)

6 (Severe ischaemic ulcers of frank gangrene)

Ulcer classification:

Infected ulcers being appropriately managed

Those meeting The University of Texas Wound classification criteria [14]:

A1, A2, A3 (wounds of varying depth without infection or ischaemia)

B1, B2, B3 (wounds of varying depth with infection only)

Wound classification:

Dry gangrenous ulcer

Fungating ulcers

Malignant ulcers

Those meeting the University of Texas wound classification criteria:

A0, B0, C0, D0 (pre or post-ulcerative lesion with complete epithelialisation, with or without infection and ischaemia)

C1, C2, C3 (wounds of varying depth with ischaemia only)

D1, D2, D3 (wound of varying depth with infection and ischaemia