Local application of phenytoin sodium in diabetic ulcers: a randomized prospective study


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Prashaanth M. K., Ramesh R., Junior Sundresh N., Nirmala P., Umapathy P and Appu Mathi Roga Rajan

Introduction: Diabetic foot ulcer is the most common complication of diabetes mellitus. Most of the patients with diabetes seek hospital admission due to a diabetic foot ulcer. About 15% of diabetic patients have ended up with surgery following diabetic ulcer complications.

Objective: The objective of this study was carried out to assess the efficacy of topical application of phenytoin sodium powder on healing in diabetic foot ulcer Category I and II.

Materials and Methods: Totally, 50 patients with diabetic foot ulcer were randomized into two groups, assigned regular saline and betadine dressing for the control group and phenytoin sodium powder application for the study group. Patients fulfilled the inclusion and exclusion criteria. Both the control and study group are compared for the reduction in the surface area, granulating tissue formation, duration of hospital stay, wound swab for culture & sensitivity and graft uptake to assess the healing process.

Results: The wound healing was assessed by the formation of granulation tissue, decrease in the surface area, wound swab for culture and sensitivity, duration of hospital stay, and the graft uptake post surgery. At the end of 14 days, the presences of healthy granulation tissue were markedly noted in 90.08% of study group with phenytoin, and it was present only in 10% of control group. Moreover, also wound reduction was 66% in the study group, and 44% in control group. Graft uptake in study group post surgery was 87.6% compared to the control group which was 65.76%. Mean duration of time in the hospital is also significantly reduced in phenytoin group which was 35.36 days compared to control group which was 5.56 days.

Conclusion: Based on this study and literature review, we conclude phenytoin sodium powder tropical application on diabetic foot ulcer promotes early wound healing.

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