A comparative study of topical phenytoin versus honey dressing in diabetic ulcer: A prospective observational study

Introduction: Diabetic foot ulcers are a frequent and serious complication of diabetes, often leading to delayed healing and increased risk of infection. Topical agents like phenytoin and honey are considered due to their affordability and reported benefits in enhancing granulation and wound healing. The aim is to compare the effectiveness of topical phenytoin versus honey dressing in the treatment of diabetic foot ulcers in terms of ulcer size reduction, number of dressings and debridements, and time to complete healing. Material and Methods: A prospective comparative observational study was conducted on 50 patients with diabetic ulcers, randomized into two groups: Group A (topical phenytoin) and Group B (honey dressing), each with 25 patients. Ulcer size was recorded on days 1, 7, 14, and 21. Other outcomes assessed included number of dressings, number of debridement procedures, rate of complete epithelialization, and mean duration for healing or readiness for split skin grafting. Data were analyzed using unpaired Student’s t-test with p< 0.05 considered significant. Results: Most participants were between 51 and 70 years of age, with mean ages of 58.8 (Group A) and 59.1 (Group B) years. There was a progressive reduction in ulcer size in both groups across 21 days. By day 21, the reduction was 55.83% in the phenytoin group and 55.008% in the honey group, without statistically significant differences (P > 0.05). The average number of debridements was equal (1.7 in both groups). Complete epithelialization occurred in 40% of patients in Group A and 36% in Group B. The mean duration for complete healing or readiness for grafting was 24.28 days in Group A and 23.2 days in Group B, again without significant difference. Conclusion: Both topical phenytoin and honey dressing demonstrated similar effectiveness in the treatment of diabetic ulcers. Although honey dressing showed slightly faster healing and required fewer dressings, these differences were not statistically significant. Further studies with larger populations are recommended to confirm these findings.