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Abstract

Background: Diabetic foot ulcers represent a significant clinical challenge with substantial morbidity and healthcare burden. Various topical agents have been employed to enhance wound healing, with phenytoin and betadine showing promising therapeutic potential. This study compared the efficacy of topical phenytoin 50mg/ml versus betadine 10% in promoting healing of diabetic foot ulcers.
Methods: A prospective comparative study was conducted involving 120 patients with diabetic foot ulcers, randomized into two groups of 60 patients each. Group A received topical phenytoin 50mg/ml dressing, while Group B received betadine 10% dressing. Primary outcomes included time to complete healing, granulation tissue formation, and epithelialization rate. Secondary outcomes encompassed bacterial load reduction and patient compliance.
Results: The phenytoin group demonstrated significantly faster healing with mean time to complete healing of 18.4±4.2 days compared to 26.7±5.8 days in the betadine group (p<0.001). Complete granulation tissue formation occurred in 85% of phenytoin-treated ulcers versus 63.3% in the betadine group (p=0.007). Bacterial load reduction was significantly greater in the phenytoin group (p=0.003), with no significant adverse effects observed in either group.
Conclusion: Topical phenytoin 50mg/ml demonstrated superior efficacy compared to betadine 10% in promoting diabetic foot ulcer healing, with faster granulation tissue formation, epithelialization, and bacterial load reduction. These findings support phenytoin as an effective therapeutic option for diabetic foot ulcer management.