A Study on Efficacy of Phenytoin on Chronic Non Healing Diabetic Ulcer

Abstract

Abstarct: Background : Chronic non healing ulcer is one the commonly faced surgical conditions by surgeons . It is one of the major cause for morbidity in diabetic patients. Inspite 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 : Our study is a randomized prospective study was conducted on 100 patients with non healing chronic diabetic ulcer. The patients are randomly divided into two groups study and control group ( Study phenytoin ; Control 5 % povidone iodine). Wound measurement and culture growth was taken on day one and end of 14 th 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% povidone 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, povidone iodine , topical phenytoin, Wound area