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Controlling Maceration in Diabetic Foot Ulcers: A Scoping Review.

Erlin Ifadah1,2,3,4, Mao Kunimitsu1,2,3,4, Mai Kitagawa1,2,3,4

  • 1Erlin Ifadah, MN , Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan; Nursing Department, Faculty of Health, Respati Indonesia University, East Jakarta, Indonesia.

Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society
|July 1, 2026
PubMed
Summary

This review summarizes methods for managing maceration in diabetic foot ulcers (DFUs). Current approaches include exudate absorption, antimicrobials, and oxidative stress reduction, but optimal strategies require further research.

Keywords:
Diabetic woundmacerated periwound skinwound care

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Area of Science:

  • Podiatry
  • Dermatology
  • Endocrinology

Background:

  • Diabetic foot ulcers (DFUs) are a serious complication of diabetes.
  • Periwound skin maceration significantly impedes DFU healing.
  • No standardized methods currently exist for managing DFU maceration.

Purpose of the Study:

  • To conduct a scoping review of existing evidence on managing maceration in DFUs.
  • To identify and categorize current management strategies for DFU maceration.
  • To highlight research gaps in DFU maceration treatment.

Main Methods:

  • A scoping review guided by the PRISMA-ScR checklist was performed.
  • Searches were conducted across four major databases: MEDLINE, CINAHL, PubMed, and Google Scholar.
  • Two independent researchers screened 1814 articles, selecting 16 that met inclusion criteria for original research or case studies on DFU maceration management.

Main Results:

  • The review identified 16 relevant studies reporting on DFU maceration management.
  • Three primary management categories emerged: exudate absorption (10 studies), antimicrobial application (5 studies), and oxidative stress reduction (1 study).

Conclusions:

  • While various methods exist for DFU maceration, evidence comparing their efficacy for different maceration severities is lacking.
  • Further research is essential to develop evidence-based guidelines for selecting appropriate management strategies based on DFU maceration severity.