Khandelwal S, Chaudhary P, Poddar DD, Saxena N, Singh RA, Biswal UC, et al.
Clinics and practice. Date of publication 2013 Feb 21;volume 3(1):e9.
1. Clin Pract. 2013 Feb 21;3(1):e9. doi: 10.4081/cp.2013.e9. eCollection 2013 Jan
25.
Comparative Study of Different Treatment Options of Grade III and IV Diabetic
Foot Ulcers to Reduce the Incidence of Amputations.
Khandelwal S(1), Chaudhary P(1), Poddar DD(1), Saxena N(1), Singh RA(1), Biswal
UC(1).
Author information:
(1)Dr Ram Manohar Lohia Hospital and PGIMER , New Delhi, India.
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.
DOI: 10.4081/cp.2013.e9
PMCID: PMC3981236
PMID: 24765502
