Abstract

Purpose We aimed to evaluate and compare the efficacy of neem leaves extract with normal saline irrigation practice in wound dressing on healing outcome and clinic-physiological parameters among individuals with diabetic foot ulcer (DFU). Methods A quasiexperimental with repeated measures design was used on two study groups. One group received neem leaf extract wound irrigation and another group received normal saline wound irrigation. Study participants were randomly assigned to each group from 100 DFU individuals. Demographic and clinical data sheets were used to collect baseline information. Random blood sugar and HbA1C measurement was performed on the initial day of visit for all participants. We used the PUSH tool for wound assessment (wound surface area, exudate amount, and tissue type), and clinic physiological parameters (temperature, pulse rate, respiration, blood pressure, wound pain, wound infection, and local warmth) assessment was performed at baseline and then at the end of each week till four weeks were completed. Participants attended a foot clinic every 3rd or 4th day for wound care. Results Reduction of wound healing score (PUSH score) and other wound variables improved significantly in the neem leaves extract group (p < 0.001). There were no significant changes in the clinic-physiological parameters. Conclusion Neem leaves extract irrigation for foot ulcers is considered to be very safe as it did not cause any complication systematically during the study. Neem leaf extract solution can be used as an alternative solution for normal saline. Managing DFU requires continuous foot care and early risk identification of ulcer.

Highlights

  • Most of the people with diabetes are at great risk of developing diabetic foot ulcer (DFU). e burden of ulcers is massive, leading to economic, social, and pressure on public health workers globally [1]. e reported worldwide prevalence of DFU was 6.3% in the year 2018. e occurrence of DFU is common in elderly people [2]

  • Our findings suggested that the control of the sugar level promoted wound healing in diabetic foot ulcers

  • Analysis of the present study revealed that both normal saline and neem leaf extract irrigation practice during wound dressing made no significant changes to body temperature, pulse rate, respiration rate, blood pressure, local warmth, and wound pain in both groups

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Summary

Introduction

Most of the people with diabetes are at great risk of developing diabetic foot ulcer (DFU). e burden of ulcers is massive, leading to economic, social, and pressure on public health workers globally [1]. e reported worldwide prevalence of DFU was 6.3% in the year 2018. e occurrence of DFU is common in elderly people [2]. Most of the people with diabetes are at great risk of developing diabetic foot ulcer (DFU). E reported worldwide prevalence of DFU was 6.3% in the year 2018. Prevalence is higher for men than for women It is higher among people with type 2 diabetes, compared with type 1 diabetes [3]. Some reasons include lack of awareness, late reports by individuals, walking barefoot, low socioeconomic status, and lack of knowledge about diabetic foot care [5]. Risk factors of foot ulceration vary from person to person, but some of them are common. Peripheral neuropathy, peripheral arterial disease, poor glucose control, poor footwear, underlying infection and duration of diabetes, cigarette smoking, and diabetic nephropathy are recognized risk factors for foot ulceration. DFU can lead to critical complications in the absence of proper care to the wounded area

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