A Prospective, Randomized, Controlled Study For Efficacy of Phenytoin Sodium Powder, Eusol Solution, Nanocrystalline Silver Gel in Diabetic Foot Ulcer

Background   Diabetic foot is one of the most significant and devastating complications of diabetes. Not all foot complications can be prevented, but it is possible to dramatically reduce their incidence through appropriate management and prevention. Various dressings are available that fulfils a number of functions like cosmesis, haemostasis, protection, support and absorption.   Objectives To study and compare the efficacy of different topical agents like phenytoin sodium powder, eusol solution, nanocrystalline silver gel in patient with diabetic foot ulcer by recording the mean ulcer size pre-treatment, during the course of treatment (1 week, 2 week, 3 week and 4 week follow up) and post- treatment and mean percentage of the wound size healing after treatment. Material & Method This prospective study was conducted in the Department of General Surgery, Geetanjali Medical College & Hospital, affiliated to Geetanjali University from January 2017 to June 2018. 90 patients with diabetic foot ulcers without any other co-morbid conditions and ulcers belonging to Grade I & II as per Wagner diabetic foot ulcers classification were compared with the efficacy of different topical agents. Results Out of 90 patients, there was a highly significant reduction in the mean ulcer size after 2 week, 3 week and 4 week follow up in nanocrystalline silver gel group (p<0.05) as compared to the phenytoin sodium powder and eusol solution group and the formation of granulation tissue was higher in nanocrystalline silver gel group (90%) as compared to phenytoin sodium powder (80%) and eusol solution (73.33%). Conclusion Dressings done with nanocrystalline silver gel was found to be more efficacious than the other topical agents in patients with diabetic foot ulcers in terms of increased rate of wound healing, greater reduction in the mean ulcer size after treatment, absence of pain, swelling and type of discharge after treatment, greater incidence of formation of granulation tissue and less duration of antibiotic therapy and hospital stay.