Role of topical phenytoin (Diphenylhydantoin) dressing in diabetic ulcers: A comparative study with conventional dressing

Abstract

Introduction: The stimulatory effect of phenytoin on connective tissue suggested possibility for its use in wound healing. Oral phenytoin was first introduced as an antiseizure medication in 1937. Over 60 years investigators have shown an interest in how topical phenytoin may be used to promote wound healing in a variety of chronic wounds. Materials and Methods: A sample of 40 patients with diabetic ulcers was selected using purposive sampling technique. The patients were divided into two groups: Group A (Phenytoin group) (n=20) and Group B (conventional group) (n=20). In Group A, the patient’s dressing were done using phenytoin and in Group B, with povidine. The patients were followed up on a daily basis for 9 days in both study and control groups. Wound culture was obtained at the start of the treatment and on the 7th day of treatment. Then the patients were subjected to split thickness skin grafting on 10th day. The follow up of the patients were done at one month after discharge in outpatient department for post skin grafting complications. Result: The mean duration of hospital stay in phenytoin group was 21.35±4.71 (SD) days and that in the conventional group was 27.3±6.48 (SD) days. One month follow up complications in conventional group were more as compared to phenytoin group. Conclusion: Topical phenytoin dressing helps in better granulation tissue formation and better graft take up than the conventional dressing. Hospital stay and post-operative complications were less in topical phenytoin dressing group as compared to conventional dressing group. Conflict of interest: Nil Source of funding: Nil