Phenytoin efficacy in treating the diabetic foot ulcer of a haemodialysis patient

Spaia, Sofia; Eleftheriadis, Theodoros; Pazarloglou, Michalis; Askepidis, Nikolaos; Ioannidis, Iraklis; Touboura, Agoritsa; Vayonas, Georgios

doi:10.1093/ndt/gfg613

Cited by 5 publications

(8 citation statements)

References 3 publications

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“…[27,28] Additional treatment options in the diabetic renal foot include VAC pump therapy and a local application of agents promoting wound closure. [96][97][98] Vacuumassisted closure (VAC) is an established technique promoting healing via a pump creating negative pressure within the wound. [27] It has successfully been applied to diabetic foot ulcers, accomplishing faster wound closure and, in most patients, eliminating the need for further surgery.…”

Section: The Diabetic Foot In Renal Failure: Prevention and Treatmentmentioning

confidence: 99%

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The Diabetic Foot in End Stage Renal Disease

et al. 2007

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Diabetic foot lesions remain a major cause of morbidity in patients with renal failure, especially those on dialysis. Foot complications are encountered at a more than twofold frequency in diabetic patients with end-stage renal disease, and the rate of amputations is 6.5-10 times higher in comparison to the general diabetic population. The causal pathways of the diabetic foot in renal failure are multiple and inter-related. Three major pathologies-neuropathy, ischemia, and infection-are the main contributory factors. Increased awareness of this condition and careful clinical examination are indispensable to avoid serious complications. Appropriate management needs to address all contributory factors. Treatment options include revascularization, off-loading to relieve high-pressure areas, and aggressive control of infection. Equally important is the collaboration between health care providers in a multidisciplinary foot care setting. Moreover, patient education on the measures required to achieve both primary and secondary prevention is of great value. Certainly, technical innovations have made considerable progress possible, but there is a need for further improvement to reduce the number of amputations.

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Section: The Diabetic Foot In Renal Failure: Prevention and Treatmentmentioning

confidence: 99%

“…[27] Experience in diabetic patients with renal failure is limited but encouraging. [27,96] Agents that have shown promise in improving the healing of the diabetic renal foot include phenytoin [97] and platelet-derived growth factor (PDGF), [98] but experience is only limited to case reports.…”

Section: The Diabetic Foot In Renal Failure: Prevention and Treatmentmentioning

confidence: 99%

The Diabetic Foot in End Stage Renal Disease

et al. 2007

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“…[8][9][10][11] Proposed actions of phenytoin include accelerated fibroblast proliferation, formation of granulation tissue and deposition of connective tissue components, as well as reduction in collagenase activity and bacterial contamination of the ulcer. 3 In most of the clinical trials investigators have used phenytoin powder from the capsules or phenytoin suspensions (2 and 4%) 2,3 since they are convenient to use.…”

Section: Discussionmentioning

confidence: 99%

Topical phenytoin solution for treating pressure ulcers: a prospective, randomized, double-blind clinical trial

et al. 2007

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Study design: Prospective, randomized, double-blind clinical trial. Objectives: To evaluate the efficacy of topical phenytoin solution in treating pressure ulcers among patients with spinal cord disorders and to evaluate the systemic absorption of topical phenytoin. Setting: Physical Medicine and Rehabilitation Unit, Christian Medical College, Vellore, India. Methods: Twenty-eight patients with stage 2 pressure ulcers were randomized to receive either phenytoin solution (5 mg/ml) or normal saline dressing on their ulcers once daily for 15 days. Efficacy of the treatment was determined by assessing the reduction in Pressure Ulcer Scores for Healing (PUSH 3.0), ulcer volume and ulcer size as on day 16. Serum phenytoin concentrations were estimated to determine the systemic absorption of topical phenytoin. Results: Statistically insignificant but marginally higher reduction in PUSH 3.0 scores and ulcer size were seen with topical phenytoin treatment. Systemic absorption of topical phenytoin was negligible. No adverse drug events were detected during the study. Conclusions: Phenytoin solution is a safe topical agent that accelerates healing of pressure ulcers. However, its efficacy is only slightly more than normal saline treatment.

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“…Recently some studies have shown that topical phenytoin promotes healing of decubitus ulcer, venous ulcer, pressure ulcer & leprosy ulcer and was found to be of superior in the management ulcers of diabetic. [1][2][3] We therefore conducted this study to evaluate the efficacy of topical phenytoin in healing of diabetic ulcers and its comparison with other dressings.…”

Section: Introductionmentioning

confidence: 99%

A comparative analysis of the efficacy of topical phenytoin with conventional wound dressing in healing of diabetic foot ulcers

et al. 2017

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Background: Foot ulcers secondary to diabetes mellitus are very difficult to treat. Various agents have been used with varying success for their treatment. Recently phenytoin has been used in the treatment of these stubborn ulcers. Therefore this study was conducted and compared for the efficacy of topical phenytoin with conventional wound dressings in healing of diabetic foot ulcers.Methods: This is a prospective study comprising of 50 patients which were divided into two groups. In group I patients conventional betadine dressing was applied. In group II patients phenytoin was used for the dressing. Both the groups were compared on various parameters like time required for healing, complications, grafting and the results were statically evaluated.Results: Increased rate of granulation tissue formation was seen in topical phenytoin group when compared to conventional group. Better graft take up was seen in topical phenytoin group when compared to conventional group. On contrasting the number of days required for healing, effect on bacterial load and side effects of topical phenytoin dressing with conventional betadine dressing, the former yielded better results in all respects.Conclusions: Topical phenytoin dressing is an effective, inexpensive and widely available therapeutic agent in wound healing in chronic diabetic ulcers.

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Phenytoin efficacy in treating the diabetic foot ulcer of a haemodialysis patient

Cited by 5 publications

References 3 publications

The Diabetic Foot in End Stage Renal Disease

The Diabetic Foot in End Stage Renal Disease

Topical phenytoin solution for treating pressure ulcers: a prospective, randomized, double-blind clinical trial

A comparative analysis of the efficacy of topical phenytoin with conventional wound dressing in healing of diabetic foot ulcers

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