Efficacy of topical recombinant epidermal growth factor as compared to Povidone Iodine on chronic diabeic foot ulcers

Abstract

Background: Diabetic foot ulcer is a common surgical complication in patient of diabetes mellitus. It is the most frequent reason for hospitalization for patients with diabetes. Still the ideal material for dressing is not known.  This study has been conducted to compare the efficacy of topical application of Povidone- Iodine with recombinant epidermal growth factor in  chronic diabetic foot ulcers of size 5 to 10 cm².

Methods: Diabetic foot ulcers which were non-healing for more than 3 months were  randomized into two groups of 30 each. Clinical examination of the ulcer and limb was  done. Ischemic ulcers, ulcers with gangrene or associated osteomyelitis were excluded. One group  had received Povidone iodine  (Betadine 10% solution) soaked dressing while other group was dressed with  Recombinant Epidermal Growth Factor gel (Eugraf 150 mcg gel) dressing  twice weekly for 12 weeks. At the end of twelve weeks ulcers were assessed for healing.

Results:There were total 60 cases from Jan 2014 till Dec 2014. Age range from 45 to 70 yrs (mean age 55 yrs). There were 45 males and 15 females (M: F:  3:1).  The ulcers were developed  most commonly in foot in 48 patients ( 80%) followed by  in lower leg around ankle in 06 patients ( 10%)  and in 10 % of cases involved foot and leg both.  Six (20%) patients on Povidone- Iodine dressing group showed complete wound healing while 23 (76%) patients on recombinant epidermal growth factor dressing group showed complete wound healing. Dressing with recombinant epidermal growth factor is the more effective than Povidone iodine dressing (P<. 001). Average healing time for complete healing for completely healed ulcers was 11 weeks in  Povidone-Iodine Dressing and 8 weeks in Recombinant epidermal growth factor  dressing group.

Conclusion: Recombinant epidermal growth factor dressing is the significantly effective dressing in comparison to Povidone-Iodine in diabetic foot  non healing ulcers of size 5 to 10 cm in size. Average time of complete healing of diabetic foot  non healing ulcers is less with topical application of Recombinant epidermal growth factor  soaked dressing as compared to Povidone – Iodine dressings.