Abhiram Maji1, Parvej Sultan2, Madhumita Mukhopadhyay3
BACKGROUND
Diabetes is a cause of many complications, one of them being foot ulcer and
gangrene. Control of diabetes and wound healing should be the aim of treatment.
Wound healing requires formation of healthy granulation tissue after wound
debridement. Topical phenytoin helps in the formation of granulation tissue,
reduces the slough and bacterial load, and promotes wound healing in diabetic
foot. It is cheap and easily available. We wanted to compare the efficacy of
phenytoin with conventional dressing (povidone iodine), local sucralfate, and Llysine
in management of diabetic foot gangrene after surgical debridement.
METHODS
This single blind multi-arm randomised controlled trial was carried out at a tertiary
care teaching hospital in Kolkata over a period of one year. Data was recorded in
a pre-designed proforma, with special emphasis on the number of days required
for the development of healthy granulation tissue and hospital stay (in days).
RESULTS
A total of 160 cases were studied. The mean age of the patients was 59.6813 ±
8.7007 years with range of 38 - 81 years and the median age was 59.0 years.
Male to female ratio was 1.9:1. The duration of diabetes varied from 2 to 23 years.
In 90 (56.3 %) patients, diabetes was controlled but it was uncontrolled in 70
(43.8 %) patients. The most common organism isolated in pus culture growth was
staphylococcus. In phenytoin group, healthy granulation tissue formed earlier in
comparison to conventional dressing with povidone-iodine or dressing with
sucralfate or L-lysine. Hospital stay period was less in case of phenytoin treated
group in comparison to other three groups.
CONCLUSIONS
In our study we found that phenytoin dressing forms healthy granulation tissue
faster; so, it can be considered as an alternative to other forms of dressing.
Hospital stay is also reduced which is beneficial for the patient.
