Prospective study of platelet derived growth factor in wound healing of diabetic foot ulcers in Indian population

Abstract

Background: Recently the world health organization reported a global prevalence of diabetes exceeding 300 million people, predicting a further 60-70% increase by the year 2030, which means India alone will have 100 million people by the year 2030.Wound healing is problematic in diabetic patients. Encouraging results have shown that PDGF application is better than good wound care alone. But the evidence to demonstrate the safety and efficacy of PDGF in diabetic ulcer is scanty.Methods: The present study was carried out at PSG Hospitals, Coimbatore, Tamil Nadu, India for a period of one year, where 50 patients with diabetic foot ulcers were included in the present study. Prospective randomized controlled trail was designed for the study. 50 patients with diabetic foot ulcers admitted in surgery wards at PSG Hospitals over a period from August 2011 to August 2012. 25 patients were in the study/treatment group, 25 patients were in the control group.Results: Out of 50, patients, 25 took treatment in the form of conventional normal saline dressings and 25 took treatment with rh - PDGF dressing once a day. Glycaemic control and adequate control of infection was maintained in both the groups. X-ray foot was taken for all patients and bony involvement was excluded. The initial area measurement was taken on day 01 and final area measurement on day 15 was taken on transparent sheet. Plannimetry was used to measure the outcome that is the target ulcer area using a transparent graph sheet. Results were calculated by using student ‘t’ test.Conclusions: The wounds in the study group treated with rh-PDGF dressing contracted more than the wounds in the control group (38.55% Vs 12.79%; P≤ 0.001- statistically significant) which indicates rh-PDGF dressing is an effective modality to facilitate wound contraction in patients suffering from diabetes. Rh-PDGF dressing is found to be more effective, safe promoter of wound healing and can be used as an adjunct to saline dressing for healing of diabetic wounds and healing of ulcers receiving PDGF was significantly faster as compared to ulcers receiving placebo.