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.
