A COMPARATIVE STUDY OF EFFECTIVENESS BETWEEN TOPICAL INSULIN VERSUS NORMAL SALINE DRESSINGS IN MANAGEMENT OF DIABETIC FOOT ULCERS

Foot ulcer is a common problem in diabetic patients and are seen as a common outpatient in General Surgery department all over the country. They result in significant morbidity, with prolonged duration of hospital stay as they present late to the hospital and due to uncontrolled diabetes mellitus, ultimately requiring major amputations in some instances. A study has been attempted using topical insulin, to determine its role in wound healing. Aims &Objectives:To compare Topical Insulin versus Normal Saline dressings in management of Diabetic foot ulcers and to know the efficacy of Topical Insulin in Diabetic foot ulcers. Methods: An interventional study was conducted on 66 patients over 18 months (from Dec 2020 to June 2022) at JSS hospital, Mysuru. 66 patients were randomized into two subgroups of 33 patients each, the control and the experimental group. Normal saline dressings were done for the 33 patients in the control group and Topical Insulin dressings were applied for the 33 patients in the experimental group. Various parameters related to wound healing, viz. size, granulation tissue, type and presence of slough, pus etc. were studied on Day 1, 7 and 15 and data compared. Results:In the experimental group, the presence of granulation tissue was 97% and it was 39.4% in controls with a p value of <0.001 showing a significant increase in granulation tissue formation in experimental group.The percentage reduction of surface area among controls was 8.8% and among experimental group was 50% with a statistically significant p value of <0.001, which represent the effectiveness of Topical Insulin in wound healing and at a faster rate. Conclusion:This study has shown that using topical Insulin, the rate of promotion of granulation tissue was increased, rapid reduction in surface area of wound, rate of wound healing was improved ultimately leading to lesser morbidity, decreased amputation rates and decreased hospital stay.