Comparison Of Octenidine Wound Gel Dressing Versus Povidone-Iodine Dressing In Healing Of Chronic Diabetic Foot Ulcers- A Randomised Controlled Trial For Period Of One Year

Abstract

Comparison of octenidine wound gel dressing versus povidone iodine dressing in healing of chronic diabetic foot ulcers- A randomised controlled trial for period of one year. Introduction DM is a widespread, non-communicable disease seen among world population.1Amongst the complication of DM, DFU is seen quite often. DF disorders consists of the ulcers over the foot related with infection, PAD and neuropathy. It is a noteworthy reason for lower extremity amputation. Infection of DFU is one among the common complications seen in DM patients. One of the major problem in health sector is antibiotic resistance. Increasing antibiotic resistance has restricted the use of systemic antibiotics. In this situation topical antiseptics with broad spectrum of activity and minimal or no resistance plays an important role in management of chronic infected ulcers. Octendine, an antiseptic known since 20 years. It has been used first in 1990 by U.K health care professionals. Till now many in vitro and animal based studies have been done in evaluating the advantages of octendine, very few clinical studies done. Specific characters of no resistance and good tissue tolerability of octenidine and very few clinical studies made us to compare healing of diabetic foot ulcers, between octenidine and povidone iodine dressings. Objectives To compare octenidine wound gel dressing versus povidone iodine dressing in healing of chronic diabetic foot ulcers in terms of mean percentage reduction in ulcer area. Methods This hospital based randomised controlled study was done between Jan 2018 to Dec 2018.Total 80 cases of chronic diabetic foot ulcers between 35-75 years were selected and randomized(SNOSE technique) in to two groups, group A(study group) octendine dressing done and group B(control group) povidone iodine dressing done . Demographic data including duration of disease, hypertension, neuropathy and HbA1c levels were recorded. The wound healing was calculated as mean reduction in ulcer area and mean percentage reduction in ulcer area. The wound healing was than compared between two groups Results Of the 80 patients, 55(68.8%) were males and most of them(48 of 80 or 60%) aged more than 55 years. 50 of 80 or 62.5% belonged to low socio economic status. All of these parameters and ulcer parameters such as mode of onset, site of ulcer showed no significant difference in distribution among the groups. Presence of neuropathy, hypertension and HbA1c levels which are implicated as risk factors for DFU healing did not show statistically significant difference in distribution between groups. Ulcer healing was early in group A (octenidine dressing group) compared to group B (povidone iodine dressing group), mean percentage reduction in ulcer area was 25.51 ± 9.26 sq.cm and 14.48 ± 6.54 sq.cm in group A and group B respectively ( p-value <0.001). The percentage of patients with bacterial growth on wound culture (D14) was 15% and 32.5% in group A and group B respectively. Conclusion When octenidine wound gel was added to the treatment regimen of the patients with diabetic foot ulcers, it has shown good progress of ulcer healing in terms of ulcer area reduction compared to povidone iodine dressing.