A study of effectiveness of topical insulin on healing of diabetic ulcers at tertiary health care centre: a cross sectional study from Puducherry
DOI:
https://doi.org/10.18203/2349-2902.isj20200587Keywords:
Topical insulin effect, Diabetic ulcers, Chronic ulcersAbstract
Background: Insulin being a growth factor was proved to stimulate angiogenesis, collagen formation, matrix formation and granulation tissue proliferation in several preclinical studies. The objective was to study effectiveness of topical insulin on healing of diabetic ulcers at tertiary health care centre.
Methods: This was a cross sectional study carried out in the Department of surgery of a tertiary health care centre during August 2018 to August 2019 so during this period there were 60 patients. Group A was given topical insulin application. Group B was given saline application. The statistical analysis was done by using SPSS 24.0 version and un-paired t-test and chi-square tests are applied as test of significance.
Results: Average time required for granulation tissue to appear (mean±SD) was significantly less in group A as compared to Group B (p<0.001, df=58, t=5.87); Average surface area of wound (mm2) at day 6th day was significantly less in group A (p<0.05, df=58,t=3.98); average depth of the wounds (mm) at day 6th day was significantly less in Group A as compared to in Group B (p<0.001, df=58, t=4.92).
Conclusions: The topical application of insulin is significantly associated with fastening of wound healing in the diabetic ulcer.
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References
ul Adrian B. Brunicardi FC, Wound Healing. In: Schwartz’s Principles of Surgery. 9th ed, Ch.9, New York, McGraw-Hill; 2005: 209-33.
Cooper L, Johnson C, Burslem F, Martin P. Wound healing and inflammation genes revealed by array analysis of ‘macrophage less’ PU.1 null mice. Genome Biol. 2004;6:5.
Bjarnsholt T, Kirketerp-Møller K, Madsen KG, Phipps R, Krogfelt K, Høiby N, et al. Why chronic wounds will not heal: A novel hypothesis. Wound Repair Regen. 2008;16:2-10.
Sasidharan S, Nilawatyi R, Xavier R, Latha LY, Amala R. Wound healing potential of elaeisguineensisjacq leaves in an infected albino rat model. Molecules. 2010;15:3186-99.
Gupta N, Gupta SK, Shukla VK, Singh SP. An Indian community-based epidemiological study of wounds. J Wound Care. 2004;13:323-5.
Dubay DA, Franz MG. Acute wound healing: The biology of acute wound failure. Surg Clin North Am 2003;3:449-67.
Goodson WH 3rd, Hung TK. Studies of wound healing in experimental diabetes mellitus. J Surg Res. 1977;22:221-7.
Hanam SR, Singleton CE, Rudek W. The effect of topical insulin on infected cutaneous ulcerations in diabetic and nondiabetic mice. J Foot Surg. 1983;22:298-301.
Mowlavi A, Andrews K, Milner S, Herndon DN, Heggers JP. The effects of hyperglycemia on skin graft survival in the burn patient. Ann Plast Surg. 2000;45:629-32.
Falanga V. Wound healing and its impairment in the diabetic foot. Lancet. 2005;366:1736-43.
Galkowska H, Wojewodzka U, Olszewski WL. Chemokines, cytokines, and growth factors in keratinocytes and dermal endothelial cells in the margin of chronic diabetic foot ulcers. Wound Repair Regen. 2006;14:558-65.
Maruyama K, Asai J, Ii M, Thorne T, Losordo DW, D'Amore PA. Decreased macrophage number and activation lead to reduced lymphatic vessel formation and contribute to impaired diabetic wound healing. Am J Pathol. 2007;170:1178-91.
Galiano RD, Tepper OM, Pelo CR, Bhatt KA, Callaghan M. Topical vascular endothelial growth factor accelerates diabetic wound healing through increased angiogenesis and by mobilizing and recruiting bone marrow-derived cells. Am J Pathol. 2004;164:1935-47.
Hanam SR, Singleton CE, Rudek W. The effect of topical insulin on infected cutaneous ulcerations in diabetic and nondiabetic mice. J Foot Surg. 1983;22:298-301.
Gerber RM, Van Ort SR. Topical application of insulin in decubitus ulcers. Nurs Res. 1979;28:16-9.
Gurtner GC, Werner S, Barrandon Y, Longaker MT. Wound repair and regeneration. Nature 2008;453:314-21.
Brem H, Tomic-Canic M. Cellular and molecular basis of wound healing in diabetes. J Clin Invest. 2007;117:1219-22.
Pandey S, Kansal S, Mangla V. Efficacy of Topical Insulin Dressings V/S Normal Saline Dressing on Diabetic Foot Ulcer - A Hospital Based Study. J Dent Med Sci. 2018;17(1):47-50
Mahidhar RV, Reddy P, Rishita M. A Study of Efficacy of Topical Insulin Therapy in the Treatment of Chronic Diabetic Foot Ulcer. J Evol Med Dent Sci. 2015;4(68):11820-3.
