Abstract

Background: Topical insulin improves wound healing by regulating oxidative and inflammatory responses. Administration of the topical insulin in the dressings enhances keratinocyte migration, catalyses angiogenesis, stimulates microvascular endothelial cell migration and endothelial tube formation, accelerates re-epithelialization, and increases fibroblastic reaction. In spite of insulin therapy and a strict adherence to diabetic diet, nearly 15% of all diabetic patients will experience non-healing lesions, which is the main reason for lower extremity amputation. Objectives: To study the effectiveness of topical insulin in the management of patients with chronic diabetic foot ulcer. Methodology: This is a Randomized Control trail, 24 patients with chronic diabetic foot ulcer, treated under the Department of General Surgery, Thiruvarur Medical College, divided into Study group/ Group A/ Topical Insulin Group consisted of 12 adult patients who received topical insulin dressing and Control group/ Group B/ normal saline group consisted of 12 adult patients, who receive normal saline dressing. Ulcer size and healing was recorded on weekly basis. Strict glycemic control was maintained in all diabetic patients. Culture and sensitivity were done every week. Results: Age, gender, size of the ulcer, fasting blood sugar, postprandial sugar, area of the ulcer, were not significantly different between the groups received topical insulin and normal saline dressing. The mean Healing Time (in Days) and Time for no Growth in Culture is significantly lower among the topical insulin group compared to the normal saline dressing group. 100% of the Group A group were Cured, whereas in Group B 91.66% were Cured and 8.33% were Lost follow up and the difference was not statistically significant. The outcomes within age and gender, among the groups were not statistically significant.

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