COMPARATIVE STUDY OF GRANULATION TISSUE FORMATION IN DIABETIC FOOT ULCER BY PHENYTOIN VS POVIDONE DRESSING

Abstract

Background– Foot ulcers and infections are the most common reason for hospital admission in people with diabetes. Gingival hyperplasia is a typical adverse effect of phenytoin (diphenylhydantoin) treatment for epilepsy. It was possible that phenytoin may be used to stimulate the healing of wounds due to its stimulating impact on connective tissue. Aims and objectives of this study to compare granulation tissue formation by topical agents(phenytoin & povidone). 100 patients with diabetic foot ulcer admitted in Gene Method- ral Surgery at Dr S.N. Medical College, Jodhpur(Rajasthan) were randomly assigned into two groups, the study group consisting of 50 patients who were treated with phenytoin dressing and 50 patients into control group who were treated with povidone dressing, assessment of granulation tissue formation done at the end of 14th day Result- The rate of granulation tissue in phenytoin group was 90.84% as compared to control group which was 80.08% which was statistically signicant (p value < 0.0001). Wound swab cultures repeated on day 14th revealed that there was 86% negative culture in phenytoin group when compared to control group of 68% which also was statistically signicant. The mean hospital stay for the patient in phenytoin group was 26.46 days and in control group, it was 31.22 days. Conclusion- By promoting broblast proliferation and reducing collagenase activity, phenytoin dressing effectively accelerates the development of granulation tissue. By virtue of its inherent antibacterial activity and indirectly through their effects on anti-inammatory cells and neovascularization, it not only accelerates granulation tissue but also decreases bacterial load as compared to conventional dressing. Phenytoin helps to improve overall results by preparing the foot ulcer for early grafting