Efficacy of topical phenytoin dressing in diabetic ulcer healing

Abstract

The study focuses on the efficacy of topical phenytoin dressings in treating diabetic foot ulcers (DFUs). DFUs are a common and severe complication of diabetes, affecting about 15% of diabetic patients in their lifetime. In India, they account for 85% of diabetes-related amputations. These ulcers are challenging to treat due to the complexity of diabetes and its effects on various bodily systems. Standard treatments for DFUs often yield unsatisfactory results, leading to the exploration of alternative therapies, such as phenytoin, an anticonvulsant discovered in 1908. Despite its primary use in managing seizures, phenytoin has demonstrated potential in promoting wound healing by stimulating fibroblast proliferation, collagen deposition, and reducing infection risk. This study, conducted over two years in the Department of Surgery at Dr. B.R.A.M Hospital, Raipur, aimed to evaluate the effectiveness of phenytoin compared to traditional treatments like betadine. Forty patients with diabetic ulcers participated, divided equally between the phenytoin and betadine treatment groups. Results showed that patients treated with phenytoin experienced greater ulcer size reduction and a significant decrease in infection rates compared to those treated with betadine. The study used various statistical analyses, including t-tests and chi-square tests, to compare ulcer healing, infection rates, and hospital stay duration between the two groups. The findings suggest that phenytoin dressings are more effective in promoting wound healing in diabetic ulcers than betadine. This is supported by significant reductions in ulcer size, improved microbial clearance, and shorter hospital stays in the phenytoin group. However, the study acknowledges the need for larger-scale, multi-center trials to confirm these results and optimize treatment protocols for diabetic foot ulcers.