Efficacy of Topical Phenytoin vs Normal Saline Dressing in Management of Diabetic Ulcers

Abstract

 Objective: To compare the outcomes of topical phenytoin vs normal saline (NS) dressings to treat diabetic foot ulcer (DFU).

Study Design and Setting: Quasi-experimental study conducted in the Department of General Surgery, Pak Emirates Military Hospital, Rawalpindi, Pakistan, from January 2024 to June 2024. The study was carried out under standardized clinical protocols, and all patients were managed in a uniform hospital environment to minimize variability in treatment practices and ensure consistency in outcome assessment.

Methodology: One hundred and ten (110) patients were segregated into two equal groups; (1) Phenytoin dressings group, (2) NS dressings group. Outcomes of these groups were compared. A statistical package for Social Sciences (SPSS) version 23 was utilized to assess the results. Data regarding demographic variables, clinical presentation, and wound characteristics were collected systematically using a structured proforma, and all patients were followed regularly to monitor progress and response to treatment.

Results: One hundred and ten (n=110) patients were equally segregated into two groups. In the Phenytoin group, 50(90.90%) patients had improvement in wound (reduction in Wagner Grade) and in NS group 40(72.72%) patients had wound improvement (p-value 0.01). In the Phenytoin group, 2(3.63%) patients developed local complications and in NS group 7(12.72%) patients had local complications (p-value 0.08). In the Phenytoin group, 46(83.63%) patients had complete healing and in NS group 37(67.27%) patients had complete healing (p-value 0.04). Additionally, patient satisfaction was higher in the Phenytoin group, reflecting better overall acceptance of the treatment modality.

Conclusion: Phenytoin dressings were found to be more effective as compared to NS dressings in promoting healing in DFU, with improved clinical outcomes and higher patient satisfaction.