A clinical study of comparision between efficacy of topical sucralfate and conventional dressing in the managment of diabetic ulcer in Tirunelveli Medical College

BACKGROUND: Sulphated saccharides, primarily sucralfate, have previously been indicated for the treatment of gastric and duodenal ulcers. In radio-labelled form, sucralfate has also been used as a diagnostic agent for the imaging of gastrointestinal mucosa, since the substance binds selectively to ulcerated areas in the stomach and upper small intestine. It has been found that sucralfate exerts an antiinflammatory effect when applied topically to the skin and to mucosal surfaces, and that sucralfate exerts a beneficial effect on wounds when applied topically on epithelial surfaces outside the digestive tract. Accordingly, the present study relates to the use of sucralfate for the preparation of a medication for topical application over the skin or to any nongastrointestinal surface. Although the evidence is not yet conclusive the clinical evidence tends to support the antiinflammatory effect and wound healing effect of sucralfate. OBJECTIVES OF THE STUDY: • To compare the efficacy of topical sucralfate with that of a control group using • conventional dressings, in the healing of diabetic ulcers in terms of: Number of days needed for healing • To study the healing properties of sucralfate in management of nongastrointestinal wounds • Rate of reduction in mean ulcer surface area • To assess the effect of topical sucralfate on bacterial load by comparing the culture and sensitivity of wound swabs before and after application of sucralfate METHODOLOGY: This was a comparative study conducted at Tirunelveli Medical College Hospital,Tirunelveli.Total of 100 patients were studied. They were separated into 2 groups through computerized randomization. Patients in Control group were treated with conventional dressing and patients in Study group were treated with sucralfate dressing and watched for the wound size reduction. RESULTS: The study group patients showed higher reduction in wound size of about 40.87%as against 15.63% of the control group with P value < 0.001. CONCLUSION: Topical application of sucralfate once daily significantly increases incidence of wound healing and reduce the time required for healing in diabetic ulcers.