Comparison of Wound Healing with and without Adjuvant Topical Oxygen Therapy in Infected Diabetic Wounds

Abstract

Diabetes mellitus (D.M) is one of the main problems in health systems and a global public health threat that has increased dramatically over the past 2 decades. Patients with D.M are prone to multiple complications such as diabetic foot ulcer (DFU). Despite of the advantages of debridement, adequate debridement must always precede the application of topical wound healing agents, dressings or wound closure techniques. Objective: The objective of the study was to compare the efficacy of adjuvant topical oxygen therapy with conventional methods and conventional methods alone in management of infected diabetic wounds. Study Design: Randomized Control Trial. Setting: Surgical Unit III, Allied Hospital, Faisalabad.

Period: 4 months from March to June 2017. Methodology: A total of 120 cases included in this study were admitted either through OPD or emergency ward. Group A (Topical oxygen therapy was given along with conventional methods). Group B (Only conventional methods of wound care were applied). All patients were given single dose IV antibiotic half an hour before induction of anesthesia. All diabetic patients were administered regular insulin to control blood glucose levels. Good debridement was done, removing all dead tissue. Simple available cellophane bag applied, sterilized with antiseptic solution, tailored according to size of affected part used tapped on open side of body of patient like tourniquet. 100% oxygen was given in bag with routinely available oxygen cylinder exposing whole affected part of body or limb. Oxygen in chamber was given for maximum one and a half hour twice daily in one sitting for 7-10 days. Gram positive, gram negative and anaerobic cover was given with antibiotics. Wound was washed daily with normal saline. After clinical improvement patient was discharged and called for follow up at outdoor on weekly basis initially and then fortnightly for 6 months. Results: Mean age was calculated as 49.56+7.02 and 49.11+6.59years in group A and B respectively. 53.33% (n=32) in group A and 58.33% (n=35) in group B were males, while 46.67% (n=28) in group A and 41.67% (n=25) in group B were females. Comparison shows that 46.67% (n=28) in group A and 26.67% (n=16) in group B had efficacy; p value was calculated as 0.02 showing a significant difference. Conclusion: Efficacy of adjuvant topical oxygen therapy with conventional methods is significantly higher when compared with conventional methods alone in management of infected diabetic wounds.

Keywords: Diabetes Mellitus, infected diabetic wounds, management, topical oxygen therapy