A comparative study of topical sucralfate versus honey dressing in the management of diabetic foot ulcer
Abstract
Background and Objectives: Local wound care is one of the mainstays in the management protocol for diabetic foot ulcers. Sucralfate and honey are inexpensive and easily available agents for local dressing. They are highly efficacious in achieving faster and better healing. Our study compares the effect of topical sucralfate with honey dressings in the management of diabetic foot ulcers.
Methods: We conducted a prospective study on 50 patients of Diabetic foot ulcer admitted indoor and were evaluated clinically. Patients were divided into Group A (n=25) and Group B (n=25). Group A patients treated with topical application of Sucralfate and Group B patients were treated with topical honey. Wounds in both groups were inspected at the end of 7 days, 14 days and 21 days. Results in the two groups were compared and interpreted.
Results: In our study, mean ulcer size was reduced in both the groups on day 7, day 14, and day21 (p>0.5). The percentage of reduction in mean ulcer size in Group A was 59.53% compared to 55.05% in Group B at the end of 21 days (p value > 0.05). Completely epithelized ulcers were 10 (40%) in Group A and 9 (36%) in Group B respectively. Complete epithelization of ulcer or ulcer bed ready for split skin grafting (primary end point of study) was 21.04 days in Group A and 23.20 days in Group B (P value < 0.05).
Conclusion: Even though topical sucralfate and honey were both found to be effective in enhancing the wound healing process in diabetic foot ulcers, topical sucralfate was found to be better when compared to honey for local application.
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References
2. Bakker K, van Houtum WH, Riley PC. 2005: The International Diabetes Federation focuses on the diabetic foot. Curr Diab Rep. 2005;5(6):436-440.
3. Leone S, Pascale R, Vitale M, Esposito S. [Epidemiology of diabetic foot]. Infez Med. 2012;20(1): 8-13.
4. Frykberg RG, Zgonis T, Armstrong DG, Driver VR, Giurini JM, Kravitz SR, et al. Diabetic foot disorders. A clinical practice guideline (2006 revision). J Foot Ankle Surg. 2006; 45(5): S1-66. doi:10.1016/S1067-2516(07) 60001-5
5. Danesh BJ, Duncan A, Russell RI. Is an acid pH medium required for the protective effect of sucralfate against mucosal injury? Am J Med. 1987;83(3B):11-13. doi:10.1016/0002-9343(87)90820-5
6. Tryba M, Mantey-Stiers F. Antibacterial activity of sucralfate in human gastric juice. Am J Med. 1987; 83(3B): 125-127. doi: 10. 1016/ 0002-9343 (87) 90841-2
7. Akarsh Y G, Nischal K. A comparative study of topical human placental extract with topical sucralfate in the management of diabetic foot ulcers. Int J Curr Res. 2016;8(03):28501-28503.
8. Nagalakshmi G, Amalan AJ, Anandan H. Clinical Study of Comparision Between Efficacy of Topical Sucralfate and Conventional Dressing in the Management of Diabetic Ulcer. Int J Scienti Study. 2017; 5 (3): 236-238. doi: 10. 17354/ ijss/ 2017/302
9. Eldeen M, Fathey R, Hasaballah A, Basal A. Topical honey versus alginate as dressing for management of wagner’s Type 2 diabetic foot ulcer. J Am Sci. 2012; 8(9): 459-464.
10. Edmonds M, Lázaro-Martínez JL, Alfayate-García JM, Martini J, Petit JM, Rayman G, et al. Sucrose octasulfate dressing versus control dressing in patients with neuroischaemic diabetic foot ulcers (Explorer): an international, multicentre, double-blind, randomised, controlled trial. Lancet Diabetes Endocrinol. 2018; 6(3): 186-196. doi: 10.1016/S2213-8587(17)30438-2. Epub 2017 Dec 20.
11. Imran M, Hussain MB, Baig M. A Randomized, Controlled Clinical Trial of Honey-Impregnated Dressing for Treating Diabetic Foot Ulcer. J Coll Physicians Surg Pak. 2015; 25(10): 721-725. doi: 10. 2015 / JCPSP.721725.
12.Prabhakar S, Mathias N, Moosabba MS. Comparative study between phenytoin and sucralfate dressing in diabetic foot ulcers. Med Int J Surg. 2017;3(1):1-3. doi: https:// doi. org/10. 26611/ 1063111
13. Shukrimi A, Sulaiman AR, Halim AY, Azril A. A comparative study between honey and povidone iodine as dressing solution for Wagner type II diabetic foot ulcers. Med J Malaysia. 2008;63(1):44-46.
14.Agarwal S, Bhardwaj V, Singh A, Khan MH, Goel S, Bharat M, Krishna J. A control clinical trial of honey-impregnated and povidone iodine dressings in the treatment of diabetic foot ulcers among northern Indian subjects. Int Wound J. 2015;6(2):7-10.
15. Moghazy AM, Shams ME, Adly OA, Abbas AH, El-Badawy MA, Elsakka DM, et al. The clinical and cost effectiveness of bee honey dressing in the treatment of diabetic foot ulcers. Diabetes Res Clin Pract. 2010 Sep; 89(3):276-81. doi: 10.1016/j.diabres. 2010. 05.021. Epub 2010 Jun 19.
16.Tsakayannis D, Li WW, Razvi S, Spirito N. Sucralfate and chronic venous stasis ulcers. Lancet. 1994; 343(8894):424-425. doi:10.1016/s0140-6736 (94)91263-7.
17. Tumino G, Masuelli L, Bei R, Simonelli L, Santoro A, Francipane S. Topical treatment of chronic venous ulcers with sucralfate: a placebo controlled randomized study. Int J Mol Med. 2008;22(1):17-23. doi: https:// doi.org/ 10.3892/ijmm.22.1.17
18. West AP, Abdul S, Sherratt MJ, Inglis TJ. Antibac-terial activity of sucralfate against Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa in batch and continuous culture. Eur J Clin Microbiol Infect Dis. 1993;12(11): 869-871. doi:10. 1007/ bf02000412
19. Dubhashi SP, Sindwani RD. A comparative study of honey and phenytoin dressings for chronic wounds. Ind J Surg. 2015;77(3):1209-1213. doi: 10.1007/s12262-015-1251-6
20. Townsend CM, Beauchamp RD, Evers BM, Mattox KL. 20th Ed. Townsend: Sabiston textbook of surgery.
21. Vardi A, Barzilay Z, Linder N, Cohen HA, Paret G, Barzilai A. Local application of honey for treatment of neonatal postoperative wound infection. Acta Paediatrica. 1998; 87(4): 429-432. doi: https://doi.org/ 10. 1111/j. 1651-2227.1998.tb01473.x
22. Subrahmanyam M. Topical application of honey in treatment of burns. Br J Surg. 1991;78(4):497-498. doi: 10.1002/bjs.1800780435
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