A prospective comparative trial of collagenase and metronidazole in the topical management of diabetic foot ulcer

Objective: To assess the efficacy of metronidazole and collagenase combination in the treatment of diabetic foot ulcers with regard to the reduction of slough formation, enhancement of granulation tissue and re-epithelization. Study design: Prospective, comparative study. Place and duration of study: Surgery department of a tertiary care teaching centre of rural Haryana, from January 2011 to February 2013. Methodology: The patients who were admitted for diabetic foot ulcers at Surgery Department of a tertiary care teaching centre during the study period were screened. 42 patients in the test group were treated with topical dressings of collagenase and metronidazole. The control group of 40 patients was treated with conventional topical dressings and bed side debridement. Ulcer’s status was noted using visual score. Results: The number of patients with no necrotic tissue was significantly higher in test group at 3rd, 4th, 5th, 6th and 7th weeks than control group. Granulation tissue was significantly higher in test group at 3rd, 4th, 5th and 6th week. The test group patients had a faster wound bed preparation resulting in faster wound cover using secondary suturing, S.S.G., flap cover at the third week itself. Conclusion: Combination of collagenase and metronidazole topical application enhanced wound healing of diabetic foot ulcer as compared to conventional treatment modalities.