Efficacy Of Topical Heparin On Diabetic Ulcerprospective Study.

Abstract

BACKGROUND: The complications of diabetes contribute to the delayed healing of diabetic foot ulcers(1). The application of topical heparin on the wound has a beneficial effect on wound healing by several mechanisms.(2) OBJECTIVES OF THE STUDY: To evaluate the efficacy of topical heparin in the treatment of Grade 1and Grade 2 diabetic ulcers in the form of analyzing and comparing wound area, granulation tissue, wound discharge, duration of hospital stay and culture sensitivity. MATERIALS AND METHOD: All patients presenting to Shri B M Patil Medical College Hospital and Research Centre, Vijayapura and in whom the diagnosis of diabetic ulcer of Grade 1 and 2were made from NOVEMBER 2018 to JUNE 2020 were included in the study. A prospective interventional study was conducted with 80 patients alternatively assigned to two groups, i.e., 40 patients to topical heparin solution dressing group (Cases) and 40 patients to conventional dressing group (10% povidone iodine). Endpoint of study was a wound ready for either secondary suturing, skin grafting. All the data were analysed using the z-test, students T-test and the results were tabulated. A "pvalue” of <0.05 was considered statistically significant.RESULTS: The reduction in the surface area of wound with time was more significant in Cases as compared to Controls. By day 14 , a significantly more number of Cases developed a healthy granulation tissue as compared to the Controls (p< 0.005).By 14 days, serous wound discharge was seen in 92.5% of case group and 70% in control group (p< 0.001).By the end of 3 weeks and 4 weeks, a significantly more number of Cases had achieved outcome as compared to Controls(72.5 % vs 32.5 %,p= 0.006 and 90.0 % vs 75.0 %,p= 0.005, respectively).The mean duration of hospital stay was significantly shorter for Cases as compared to Controls ( 21.3 days ± 6.2 days vs 26.7 days ± 6.4 days, p< 0.001).CONCLUSION: Topical heparin dressing can be considered as a superior option in the management of diabetic ulcers. Nevertheless, we advocate further studies with a larger sample size to substantiate the findings we made.