Topical Insulin and Normal Saline in Chronic Diabetic Foot Ulcers- A Prospective Analytical Study

Introduction: Diabetic foot ulcers are important diabetes-related microvascular complications aggravated due to multiple pre-existing factors such as peripheral arterial disease, immune system factors, bone abnormalities, diabetic neuropathy, infections and repetitive external or minor trauma. Diabetic foot ulcers could lead to lower limb amputation if not managed appropriately. Aim: To evaluate the use of topical insulin in chronic diabetic foot ulcers at a tertiary care centre. Materials and Methods: This prospective analytical study of 12 months duration was conducted in Department of Surgery, in diabetic patients between the age group of 25 to 70 years, presenting for the first time with diabetic foot ulcer. A total of 60 patients were divided into two groups alternately as group A patients underwent dressing with topical insulin and group B patients underwent dressing with regular normal saline. Sterile transparent gauze was placed on the wound to mark the wound borders and the wound area measured. With the help of ruler the two largest perpendicular diameters were measured and these were multiplied to obtain the wound area in cm2. Ulcers were cleaned with normal saline and a sterile gauze soaked with Human mixtard insulin and normal saline. Four units of 0.1 mL-Human mixtard insulin with 1 mL normal saline used for each 10 cm2 of wound in group A. Data was analysed by using SPSS software. Chi-square test was used and p-value of