<![CDATA[Diabetic foot ulcers (DFUs) represent a severe complication of diabetes mellitus associated with significant risks of infection, lower-extremity amputation, and substantial healthcare burden. Although debridement is established as an essential component of DFU management, the comparative clinical effectiveness across different debridement modalities remains varied. This systematic literature review evaluated and synthesized current evidence regarding various debridement methods in DFU management following the PRISMA 2020 guidelines and SWiM framework. A structured search was performed across PubMed, ScienceDirect, SpringerLink, Wiley Online Library, MDPI, and Google Scholar for publications from 2018 to 2025. Methodological quality was appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Twelve primary studies (7 RCTs, 1 quasi-experimental, 1 prospective comparative, and 3 case series) met the inclusion criteria. Current evidence suggests that enzymatic debridement and ultrasonic-assisted wound debridement (UAWD) demonstrate promising trends in accelerating tissue preparation and wound size reduction. Sharp or surgical debridement remains the primary first-line approach for immediate removal of nonviable tissue and biofilm disruption. Autolytic, biological, and hydrosurgical modalities offer potential benefits in specific clinical contexts, though available comparative data remain limited. Overall, while several advanced modalities show favorable evidence for specific parameters, no single debridement technique can be conclusively defined as universally superior across all clinical outcomes.]]>
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