Table A.2.

Overview of the included studies

Author, Year	Total studies included (n)	Total and study design	Debridement method wound types	Results
	Study range of year
	Total sample
Mechanical debridement
Shimada et al. (2021) [5]	•n = 7 •Jan 1, 2000–Aug 10, 2020 •Adult = 645	Prospective RCT = 2 Retrospective RCT = 2 Case series = 3	•Hydro-surgery •Chronic wound	•A total of 8.87 min faster compared with the conventional methods. •Fewer debridement numbers needed •Considering its speed and quality, this method may benefit patients with chronic wounds
Kakagia & Karadimas (2018) [4]	•n = 20 •2005–Oct 10, 2016 •Adults = 339; Paediatric = 91	Prospective RCT = 3 Prospective = 1 Non-controlled prospective = 3 Retrospective = 7 Case series = 6	•Hydro-surgery •Burn wound	•Limited evidence regarding the efficacy and safety of the method •No significant differences compared to the surgical debridement •Fair and limited evidence on cost-effectiveness •More prospective RCT with long-term follow-up is required establish the superiority of the method over conventional surgical debridement
Michailidis et al. (2018) [6]	•Systematic Review n = 4, Meta analysis, n = 2 •Earliest data – April 2017 •Adults = 173	RCT = 3	•Non-surgical sharp debridement (NSSD) versus LFUD •Diabetes-related foot ulceration	•Results are inconclusive •Difference was not significant in healing time •Well-designed, controlled clinical studies are needed
Chang et al. (2017) [7]	•n = 25 •2000 to 2017 •Adults = 850	RCT = 1 Non-RCT = 3 Case report/case series, = 21	•LFUD •Chronic Wound (mainly pressure injury, venous/atrial leg ulcer)	•Low frequencies sound ranging between 20 and 34 kHz reported better results •The treatment frequency (3 times per week) •LFUD can be performed at least three weeks in a row •Potential in decreasing exudate and slough •Less pain, disperse biofilms •Increase healing in wounds of various etiology.
Biological debridement
Greene et al. (2021) [8]	•n = 6 •Jan 2020–May 2021 •Adults = 531	RCT = 6	•Larval therapy •Venous leg ulcers	•Effective method of debridement for venous leg ulcer •Debride faster than hydrogel •Have similar effect with sharp debridement •Greater effect of debridement when combined with compression •Did not improve overall healing •Pain increase during larval therapy
Mohd Zubir et al. (2020) [9]	•n = 5 •Inception -Oct 2020 •Adults = 580	RCT = 3 Comparative studies = 2 (580 participants)	•Maggot debridement therapy (MDT) compared to hydrogel dressings •Chronic wounds.	•Lucilia sericata used in the majority of studies •Faster, more effective debridement of non-viable tissue compared to hydrogel •No effect on disinfection and complete healing rate
Enzymatic debridement
Patry & Blanchette (2017) [10]	•n = 22 •Study Range (no restriction) •Adults = 927	RCT = 19 Cost-effectiveness RCT related studies = 2 Erratum reference = 1	•Enzymatic debridement with collagenase •Wounds and ulcers	•Ability to remove necrotic or devitalized tissues in pressure injury, diabetic foot ulcer, and burn with topical antibiotics •Meta-analysis reported that patients treated with collagenase have an increased risk of adverse events compared to an alternative treatment •Lack of RCTs with sound methodological quality; included studies had a high risk of bias