A Comparative Study of Efficacy of Topical Phenytoin vs Conventional Wound Care in Diabetic Ulcers

Abstract

A common side effect of phenytoin (diphenylhydantoin) treatment for epilepsy is gingival hyperplasia. This stimulatory effect of phenytoin on connective tissue suggested possibility for its use in wound healing. Aims: The objective of this study was 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. Methods and Material: In this quasi-experimental study, the data from 200 patients with diabetic ulcers was collected, 100 patients underwent topical phenytoin dressing, remaining 100 patients underwent conventional wound care. The results were compared after 14 days. The variables compared were: rate of granulation tissue formation as percentage of ulcer area covered, percentage of graft take up and duration of hospital stay. Statistical analysis used: The categorical variable was compared by chi-square test and continuous variables by Student t-test. A p value <0.05 was considered significant. Results: In study group , the mean rate of granulation tissue formation was 87.94% , mean graft take up was 92.31% and mean hospital stay was 32.26 days with negative culture sensitivity was 70%. The control group showed, the mean rate of granulation tissue formation was 74.64%, the mean graft take was 86.15% of total ulcer surface area and mean hospital stay was 54 days with negative culture sensitivity was 54% Conclusions: Topical phenytoin helps in faster healing with better graft take up and reduces hospital stay.