Title: Efficacy of Phenytoin on Chronic Non Healing Diabetic Ulcer - A Prospective Study
Authors: Vijay Kumar. N, Mohan K, Sunil Kumar M, Mano Ananth A.B
DOI: https://dx.doi.org/10.18535/jmscr/v6i8.139
Abstract
Background: Chronic non healing ulcer is one of the major cause for morbidity in diabetic patients. In spite of various types of dressing agents available, choosing an appropriate dressing is a challenging aspect in the management of diabetic ulcer. Topical phenytoin causes rapid wound remodeling in non-healing ulcers and its application in wound healing needs further study.
Objective: To assess the efficacy of topical phenytoin compared to conventional wound care in improving the healing process and to prove it as a relatively low cost and easy to use option in the management of diabetic ulcers.
Methodology: This is a prospective study conducted in the Department of plastic surgery, K R Hospital on 100 patients with non-healing chronic diabetic ulcer during the period of November 2013 to June 2015. The patients are randomly divided into two groups study (phenytoin) and control (5% povidine iodine group. Wound measurement and culture growth was taken on day one and end of 14th day. Mean reduction in ulcer area and culture growth at the end of 14 days was noted.
Results: There was no statistical difference in the baseline characteristics like age, sex, initial and final wound area of the ulcer between the two groups. The mean reduction in wound area was 6976.1 ± 1441.5 mm in patients treated with topical phenytoin .dressings and 1960.7± 280.4 mm in patients treated with 5% povidine iodine dressings, which is statistically significant (p < 0.001).
Conclusions: Phenytoin has a fibroblast proliferating and anti-bacterial property which can be used in faster healing for chronic diabetic ulcers as topical agent thereby reducing its systemic side effects.
Keyword: Diabetic ulcers, povidine iodine, topical phenytoin, Wound area.
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