Effect of papain urea versus hydrogen peroxide in diabetic foot ulcer management

Authors

  • Maloth Rakesh Department of General Surgery, Government Medical College, Kottayam, Kerala, India
  • Jomine Jose Department of General Surgery, Government Medical College, Kottayam, Kerala, India

DOI:

https://doi.org/10.18203/2349-2902.isj20231384

Keywords:

Diabetes, Hydrogen peroxide, Papain urea, Wagner’s grade

Abstract

Background: Diabetic foot ulcers are the most common complications in diabetic patients. Debridement of an ulcer play a vital role in the healing of diabetic foot ulcers. Medical methods of debridement have an advantage as it is also painless and can be done on OPD basis. Aim of this study was to compare the effectiveness of debridement using papain urea dressing as against hydrogen peroxide in diabetic foot ulcer management.

Methods: Patients who have a diabetic foot ulcer reporting to the hospital were studied using either hydrogen peroxide or papain urea dressings. All were brought under adequate glycemic control. Emperically oral antibiotics are started to all patients and changed according to culture and sensitivity reports after three days. Patients was randomly allocated to receive either H2O2 or papain urea dressings, 63 per set. Statistical analysis was done using the SPSS software. Significance level was fixed at p value of p<0.05.

Results: It was seen that PAPAIN UREA ointment is a better agent in debridement when compared to hydrogen peroxide. All 63 patients started showing features of reduction in ulcer size and area of slough. This difference was statistically significant.

Conclusions: In diabetic foot ulcer, papain urea dressings help in wound healing by decreasing the duration of healing time and by faster slough removal. It promotes granulation, without any complications. Hence papain urea dressings are a good option for debridement and wound healing in diabetic foot ulcer.

References

World Health Organization. Global report on diabetes, 2016. Available at: https://www.who.int/ publications-detail-redirect/9789241565257. Accessed on 23 June 2022.

Joshi SR, Parikh RM. India diabetes capital of the world: now heading towards hypertension. J. Assoc. Physicians. India. 2007;55:323-4.

Kumar A, Goel MK, Jain RB, Khanna P, Chaudhary V. India towards diabetes control: Key issues. Australas Med J. 2013;6(10):524-31.

Amaral A, Homem L, Gomes M, Campissi L, Jose M, Antonio M, et al. Prevention of lower limb lesions and reduction of morbidity in diabetic patients: Revistabrasileira de ortopedia. 2014;49(5):482-87.

Vijaykumar H, Pai SA, Pandey V, Kamble P. Comparative study of collagenase and papain-urea based preparations in the management of chronic non debridement limb ulcers. Indian J. Science and Tech. 2011;4(11):1096-106.

Smith F, Dryburgh N, Donaldson J, Mitchell M. Debridement for surgical wounds. Cochrane Database Systematic Revi. 2013(9).

Murthy MB, Murthy BK, Bhave S. Comparison of safety and efficacy of papaya dressing with hydrogen peroxide solution on wound bed preparation in patients with wound gape. Ind J Pharmacol. 2012;44(6):784.

Sarabahi S. Recent advances in topical wound care. Indian J Plast Surg. 2012;45(2):379-87.

Smith RG. Enzymatic debriding agents: an evaluation of the medical literature. Ostomy Wound Manage. 2008;54(8):16-34.

Ramundo J, Pike C, Pittman J. Do prophylactic foam dressings reduce heel pressure injuries?. J Wound Ostom Contin Nurs. 2018;45(1):75-82.

Smith J. Debridement of diabetic foot ulcers. Cochrane Data System Review. 2002(4):CD003556.

Morrison JE, Casali JL. Continuous proteolytic therapy for decubitus ulcers. American J Surg. 1957;93(3):446-8.

Jain AK, Joshi S. Diabetic foot classifications: Review of literature. Medi Sci. 2013;2(3):715-21.

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Published

2023-04-29

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Section

Original Research Articles