Pressure off-loading Mandakini dressing versus conventional wet gauze dressing in the treatment of neuropathic plantar ulcers: a randomized controlled trial

Sreenivasan Sanjeev, Thirugnanasambandam Nelson, Sathasivam Sureshkumar, Sadasivan Jagdish, Chinnakali Palanivel


Background: Plantar ulcers are one of the significant causes of morbidity in diabetic and non- diabetic neuropathic foot and remain a major initiating event for amputation. This randomized controlled trial was carried out to establish the benefits of the 'Mandakini' dressing in comparison with conventional wet gauze dressings, in patients with neuropathic plantar ulcers.

Methods: The treatment group received ‘Mandakini’ dressing which was changed every week. Control group received conventional wet gauze dressings. Size of the ulcer, grade of the ulcer and wound surface area was assessed at the end of every week up to 6 weeks in both groups. The percentage of wound covered with granulation tissue, the percentage of wound covered with non-viable tissue and the time taken for healing of the ulcer were compared between the two groups.

Results: A total of 60 patients were randomized into treatment and control group with 30 patients in each. The ‘Mandakini’ dressing group had a significant reduction in the wound size at 6 weeks compared to the control group (1.29 vs. 2.31 cm2; p ≤0.0001). Time taken for healing of the ulcer was significantly less in ‘Mandakini’ dressing group (4.83 vs. 5.4 weeks; p=0.013).

Conclusions: Mandakini dressing significantly reduces the wound size and time taken for the healing of plantar ulcer compared to conventional wet gauze dressing. Patient acceptability, patient satisfaction, quality of life and cost of the total treatment were better in Mandakini dressing group.


Mandakini dressing, Off-loading pressure techniques, Neuropathic foot, Plantar ulcers

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