Efficiency of topical phenytoin in diabetic foot ulcer care: A randomized control trial

Abstract

Aim: To study the efficiency of topical phenytoin on healing in diabetic foot ulcer grades 1 and 2. Methods: Totally, 60 patients in each group with diabetic foot ulcers of more than 4 weeks duration without any co-morbid conditions and ulcers belonging to Grade 1 and 2 as per Meggitt – Wagner’s diabetic foot ulcers were inducted into the study. The whole sample population was divided into two equal and comparable groups based on willingness for undergoing topical phenytoin therapy for the wound. Those who were not willing were subjected to conventional wound care, forming the control group. Antibiotics are given to both groups as per culture reports. Results: In the study group, 13 patients had granulation tissue at 14 days of less than 75%, and 17 patients had granulation tissue at 14 days of greater than 75%. In the control group mean value of the size of the ulcer initially is 8.76cm and in 7 days is 7.12 cm and in 14 days is 5.86 cm. In the study group mean value of the size of the ulcer initially is 9.03 cm and in 7 days is 5.63 cm and in 14days is 3.3 cm. Conclusion: Phenytoin enhances wound healing via the following mechanisms: stimulation of fibroblast proliferation, enhancement of granulation tissue development, and inhibition of collagenase activity.