Comparative study of different treatment options of grade III and IV diabetic foot ulcers to reduce the incidence of amputations

  • Poras Chaudhary | drporaschaudhary@yahoo.com Dr Ram Manohar Lohia Hospital and PGIMER, New Delhi, India.
  • Sachin Khandelwal Dr Ram Manohar Lohia Hospital and PGIMER, New Delhi, India.
  • Dev Datta Poddar Dr Ram Manohar Lohia Hospital and PGIMER, New Delhi, India.
  • Neeraj Saxena Dr Ram Manohar Lohia Hospital and PGIMER, New Delhi, India.
  • Rana A.K. Singh Dr Ram Manohar Lohia Hospital and PGIMER, New Delhi, India.
  • Upendra C. Biswal Dr Ram Manohar Lohia Hospital and PGIMER, New Delhi, India.

Abstract

This study aims to compare the efficacy of antiseptic dressings, hyperbaric oxygen therapy, and recombinant human platelet derived growth factor (rhPDGF) for two reasons: i) to reduce the incidence of lower limb amputations in diabetic foot ulcer; ii) to limit the duration of stay in the hospital. A prospective randomized trial was conducted on 60 patients with stage III and IV diabetic foot ulcers (International Association of Enterostomal Therapy classification) and patients were divided randomly in three different therapy groups - antiseptics, hyperbaric oxygen therapy, recombinant platelet derived growth factor, with 20 patients in each group. Patients were managed initially on inpatient and then on outpatient basis till the ulcer healed completely. Results among three groups were compared using unpaired T test and the level of significance was set at P<0.05 using ANOVA. This study compares the efficacy of hyperbaric oxygen therapy, antiseptic dressings, and rhPDGF in grade III and IV diabetic foot ulcers. P value (0.0348) was significant for complete wound contraction while p value healing time (0.6534) and ulcer size (0.0593) in the groups was not significant. PDGF is safe, effective and easy to apply. Results are comparable with hyperbaric oxygen (HBO) therapy and cost of treatment is lower than other therapies. Diabetic foot ulcer management requires multidisciplinary and aggressive approach. PDGF should be recommended for all grade III and IV diabetic foot ulcer at least 8 weeks old. HBO is equally good an option but has limitations and side effects.

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Author Biography

Poras Chaudhary, Dr Ram Manohar Lohia Hospital and PGIMER, New Delhi

Assistant Professor

 

Published
2013-02-21
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Articles
Keywords:
diabetic foot ulcers, antiseptic dressing, hyperbaric oxygen therapy, platelet derived growth factor gel.
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How to Cite
Chaudhary, P., Khandelwal, S., Poddar, D. D., Saxena, N., Singh, R. A., & Biswal, U. C. (2013). Comparative study of different treatment options of grade III and IV diabetic foot ulcers to reduce the incidence of amputations. Clinics and Practice, 3(1), e9. https://doi.org/10.4081/cp.2013.e9