Analysis of outcome of diabetic foot ulcer following topical phenytoin and betadine use: a comparative study

Arshad Azeez, N. S. Venkatesh, T. Shivakumar


Background: Diabetic ulcer is the major cause of morbidity and excess hospital care cost for the patients with diabetes and most frequent reason for hospitalization in patients. Diabetic foot ulcers precede almost 85% of amputations in India. Though there are many modes for care of the wound, treating diabetic wounds are still an enormous problem. Aim of the study was to analyse the outcome of topical phenytoin dressing as compared to conventional wound dressing in diabetic ulcers and thus to know if phenytoin is a better and cheaper alternative option in the management of diabetic ulcers

Methods: A sample of 90 patients were selected using purposive sampling technique. Of which 45 underwent topical phenytoin dressings, remaining 45 underwent conventional wound care. Daily dressing was done for 14 days and then was subjected to split skin grafting. The variables were compared based on rate of granulation tissue formation, graft uptake & duration of hospital stay. The categorical variable was compared by chi square test and continuous variable by student t-test. A p value <0.05 was considered significant.

Results: In Phenytoin group, mean rate of granulation tissue formation was 92.51%. Mean graft up-take was 92.98% and mean hospital stay was 35.68 days. In Conventional group, mean rate of granulation formation was 83.31%. The Mean graft up-take was only 78.09%, mean hospital stay was 47.31 days.

Conclusions: Topical phenytoin helps in faster healing of the diabetic ulcer and better graft up-take and reduces hospital stay.


Diabetic ulcers, Graft take up, Rate of granulation tissue formation, Topical phenytoin wound dressing

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Pendsey SP. Understanding diabetic foot. Int J Diabetes Dev Ctries. 2010;30(2):75-9.

Kimball OP, Horan TN. The use of Dilantin in the treatment of epilepsy. Ann Intern Med. 1939;13(5):787-93.

Muthukumarasamy MG, Sivakumar G, Manoharan G. Topical phenytoin in diabetic foot ulcers. Diabetes Care. 1991;14(10):909-11.

Pendse AK, Sharma A, Sodani A, Hada S. Topical phenytoin in wound healing. Int J Dermatol. 1993;32(3):214-7.

Brofeldt BT, Cornwell P, Doherty D, Batra K, Gunther RA. Topical lidocaine in the treatment of partial-thickness burns. J Burn Care Rehabil. 1989;10(1):63-8.

Bansal NK, Mukul Comparison of topical phenytoin with normal saline in the treatment of chronic trophic ulcers in leprosy. Int J Dermatol. 1993;32:210-3.

Nine-year effects of 3.7 years of intensive glycemic control on cardiovascular outcomes. Group, accord Study. Diabetes care. Am Diabetes Assoc. 2016;39:701-8.