The efficacy of topical phenytoin in the healing of diabetic foot ulcers: a randomized double-blinded trial

  • Raghunath Prabhu
  • Chandni Ravi
  • Srinivas Pai
  • Gabriel RodriguesEmail author
Original Article


A randomized, double-blinded, controlled clinical trial was conducted to assess the efficacy of topical phenytoin compared to conventional wound care in improving the healing process and to prove it as a relatively low-cost and easy-to-use option in the management of diabetic ulcers. Patients over 18 years of age with type 2 diabetes and foot ulcers over 1 month duration were randomized to receive daily dressings containing either powder A (test powder containing topical phenytoin and metronidazole) or powder B (control powder containing topical metronidazole) for 14 days, following which, they underwent split-skin grafting. The percentage of decrease in the ulcer surface area, rate of granulation tissue formation, graft uptake, and percentage of negative culture sensitivity were compared between the two groups using the unpaired Student’s t test. A p value <0.05 was considered significant. Patient demographic and socioeconomic characteristics of the two groups were well matched. The primary outcome measured as the mean rate of decrease of size of the ulcer in patients of group A was 30.69 (±5.50 SD) and in group B was 24.43 (±5.96 SD) percent of total ulcer area (p < 0.0001). The mean rate of increase of granulation tissue in group A was 69 (±10.16 SD) percent of total ulcer area and in group B was 51.51 (±10.54 SD) percent of total ulcer area (p < 0.0001). Out of the 97 patients, 75 underwent grafting. The mean graft take up in group A was 76.57 % (±19.06 SD) and in group B was 66.48 % (±17.67 SD) (p = 0.0082). Forty-three percent of the study group was culture negative at day 14, of which 54.2 % belonged to group A as compared to 45.8 % in group B. Topical phenytoin is an effective, inexpensive, and easily available agent in the promotion of healing of diabetic foot ulcers.


Diabetes Ulcer Healing Phenytoin Surgery 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Source of funding


Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Research Society for Study of Diabetes in India 2016

Authors and Affiliations

  1. 1.Department of General Surgery, Kasturba Medical CollegeManipal UniversityManipalIndia

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