Efficacy of topical phenytoin in healing diabetic foot ulcer
Keywords:Diabetic foot, Standard and conventional normal saline dressing, Topical phenytoin
Background: India is fast becoming world diabetes capital. Complications are a cause of hospitalization in patients with diabetes mellitus especially foot complications. Gauze moistened with saline has been the standard method.
Methods: The study was done from June 2015 to June 2016. The objective of this study was to assess the efficacy of topical phenytoin compared to standard and conventional methods of wound care in improving the healing process. In this randomised control trial, the data from 70 patients with diabetic ulcers was collected, 35 patients underwent topical phenytoin dressing while remaining 35 underwent conventional wound care. Histopathological and Clinical examination were done and the following parameters were calculated: Granulation tissue formation in 2 weeks and Mean duration of hospital stay.
Results: In this study, Mean hospital stay in days was 33.4 in Phenytoin treated group and in other group with use conventional materials, the mean hospital stay in days was 39.7 days. Granulation tissue formation was faster as compared to conventional materials of Dressings.
Conclusions: In this study we conclude Topical phenytoin helps in faster healing of Diabetic Foot Ulcers and it also reduces the mean hospital stay of the patients.
Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. AMJ. 2014;7:45-8.
Pendsey SP. Understanding diabetic foot. Int J Diabetes Dev Ctries. 2010;30:75-9.
Viswanathan V, Shobhana R, Snehalatha C, Seena R, Ramachandran A. Need for education on footcare in diabetic patients in India. J Assoc Physicians India. 1999;47:1083-5.
White R, McIntosh C. Topical therapies for diabetic foot ulcers: standard treatments. J Wound Care. 2008;17:426-32.
Muthukumarasamy MG, Sivakumar G, Manoharan G. Topical phenytoin in diabetic foot ulcers. Diabetes Care. 1991;14:909-11.
DaCosta ML, Regan MC, al Sader M, Leader M, Bouchier-Hayes D. Diphenylhydantoin sodium promotes early and marked angiogenesis and results in increased collagen deposition and tensile strength in healing wounds. Surgery. 1998;123:287-93.
Shaw J, Hughes CM, Lagan KM, Stevenson MR, Irwin CR, Bell PM. The effect of topical phenytoin on healing in diabetic foot ulcers: A randomized controlled trial. Diabet Med. 2011;28:1154-7.
Meritt HH, Putnam TJ. Sodium diphenyl hydantoinate in the treatment of convulsive disorders, JAMA. 1938;111:1068-73.
Bethedsa M.D., 2001, ASHP drug information 2001, American Society of Health System Pharmacists, 2081.
Genever PG, Cunliffe WJ, Wood EJ. Influence of the extracellular matrix on fibroblast responsiveness to phenytoin using in vitro wound healing models. Br J of Dermatol. 1996;133:231-5.
Dill RE, Miller EK, Weil T, Lesley S. Phenytoin increases gene expression for platelet - derived growth factor in β chain in macrophages and monocytes. J peridontol. 1993;64:169-73.
Pendse AK, Sharma A, Sodani A, Hada S. Topical phenytoin in wound healing. Int J Dermatol. 1993;32:214-7.
Anstead GM, Hart LM, Sunahara JF, Liter ME. Phenytoin in wound healing, Ann Pharmacol. 1996;30:768-75.
Pai MR, Sitaram N, Kotian MS. Topical phenytoin in diabetic ulcers: A double blind controlled trial, Indian J Med Sci. 2011;55:593-9.
Tauro LF, Shetty P, Dsouza NT. A comparative Study of Efficacy of Topical Phenytoin vs Conventional Wound Care in Diabetic Ulcers. International Journal of Molecular Medical Science. 2013;3(8).
Jayalal JA, Kumar SJ, Dhinesh, Thambithurai D, Kadar JMA. Efficiency of Topical Phenytoin on Healing in Diabetic Foot Ulcer: A Randomized Controlled Trial. Int J Sci Stud. 2015;3(3):84-9.