The impact of topical phenytoin on recalcitrant neuropathic diabetic foot ulceration

Journal of Wound Care
M El-NahasO State

Abstract

To study the impact of topical phenytoin on the healing of recalcitrant neuropathic diabetic foot ulcers in patients with no clinical evidence of ischaemia or infection, and to evaluate its antibacterial effect. Thirty-two patients were enrolled into the study. Topical phenytoin in the form of 2% aerosol powder was applied once daily in addition to the patient's usual treatment (weekly sharp debridement, offloading and use of a gauze dressing) for eight weeks. The primary outcome was change in ulcer area over time, measured by grid tracing. Secondary outcomes were the ability of topical phenytoin to eradicate bacterial isolates, and the occurrence of adverse events. Topical phenytoin significantly improved healing of recalcitrant neuropathic diabetic foot ulcers. Baseline wound area was 319.3 + 340.4 mm2, reducing to 286.1 + 341.1 mm2 and 269.1 + 341.2 mm2 after four and eight weeks respectively. However, the overall reduction in ulcer size was only 18.3% + 27.5% and 25.7% + 38.6 % respectively. Topical phenytoin therapy over eight weeks did not eradicate any of the bacterial wound isolates (Staphylococcus spp., Proteus spp. or Pseudomonas spp.). Of the 32 patients evaluated, only eight (25%) achieved more than 50% reduction in...Continue Reading

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Citations

Mar 15, 2016·The Journal of Dermatology·Taiki IseiUNKNOWN Wound/Burn Guidelines Committee
Feb 23, 2011·International Journal of Surgery·Emad HokkamMamdouh El-Mezaien
Aug 25, 2010·BMC Dermatology·Carlos Augusto Zanardini Pereira, Alice de Oliveira de A Alchorne
Oct 29, 2015·International Wound Journal·Yi-Shan LiuChia-Ju Liu
Jul 29, 2010·Journal of Diabetes Science and Technology·Christy L ScimecaDavid G Armstrong
Mar 29, 2014·Revista da Escola de Enfermagem da U S P·Flávia FirminoLúcia Helena Garcia Penna
Sep 29, 2017·Drug Development and Industrial Pharmacy·Amira MotaweaAbd El-Gawad H Abd El-Gawad
Apr 19, 2020·Current Pharmaceutical Design·Myla Lôbo de SouzaPedro José Rolim-Neto

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