Daily Chlorhexidine Wipes Do Not Significantly Reduce Diabetic Foot Complications, JAMA

Participants were supplied with lookalike wipes for blinding. The main outcome was time to first new foot complication, occurring after randomization and defined as chronic foot ulcer, foot infection, or amputation of a lower extremity. Data analysis was performed in an intention-to-treat fashion. Follow-up occurred over one year's median duration, during which adverse effects and intervention compliance were closely observed.

Key Findings

• In a year, 12 (14%) and 14 (16%) participants in the chlorhexidine and soap-and-water groups, respectively, developed new foot complications.

• The time to the first new foot complication was 232 days (IQR: 115-315 days) in both groups.

• No significant hazard reduction of new foot complications in the chlorhexidine group was seen compared with the soap-and-water group (hazard ratio, 0.83; 95% CI, 0.39-1.80).

• 60 adverse events were documented throughout the study, but none of them resulted from the intervention. The adherence was very high with 145 participants (83%) sustaining the intervention during the entire study period.

The study authors concluded that daily use of 2% chlorhexidine wipes did not significantly influence prevention of new diabetic foot complications among diabetic veterans in comparison with soap-and-water wipes. These findings are valuable for future research regarding how to optimize preventive interventions for diabetic foot complications.

Reference:

Lydecker AD, Kim JJ, Robinson GL, et al. Chlorhexidine vs Routine Foot Washing to Prevent Diabetic Foot Ulcers: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(2):e2460087. doi:10.1001/jamanetworkopen.2024.60087