Comparison of Offloading Dressing with Conventional Dressing in Healing of Plantar Diabetic Foot Ulcers: A Randomised Clinical Trial
Introduction: The first ever description of Diabetic Foot Ulcers (DFUs), made in the literature was in the mid 19th century. The management principles for it were laid by late 19th century and are still being followed. For a chronic DFU to heal, offloading of pressure, surgical debridement, corr...
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Format: | Article |
Language: | English |
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JCDR Research and Publications Private Limited
2022-10-01
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Series: | Journal of Clinical and Diagnostic Research |
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Online Access: | https://jcdr.net/articles/PDF/16999/49942_CE(AnK)_F(KR)_PF1(PS_OM)_PFA(SS)_PB(PS_SS)_PN(SS).pdf |
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author | Shraddha Modi T Tirou Aroul |
author_facet | Shraddha Modi T Tirou Aroul |
author_sort | Shraddha Modi |
collection | DOAJ |
description | Introduction: The first ever description of Diabetic Foot Ulcers
(DFUs), made in the literature was in the mid 19th century. The
management principles for it were laid by late 19th century and
are still being followed. For a chronic DFU to heal, offloading of
pressure, surgical debridement, correction of hyperglycaemia,
the use of antibiotics are the corner stone of management.
Offloading is an essential modality of prevention and treatment
of recurrent plantar DFU.
Aim: To compare offloading dressing to conventional dressing
in promoting healing of diabetic plantar foot ulcers.
Materials and Methods: This randomised clinical trial was
conducted at Mahatma Gandhi Medical College and Research
Institute, Pondicherry, India, between January 2019 to June
2020 among the patients with DFU coming to the Department
of General Surgery. A total of 44 patients were included in the
study, 22 of these patients underwent offloading dressing and
22 underwent conventional dressing and these patients were
followed-up for a duration of 6 weeks and compared on 2nd, 4th
and 6th weeks. The patients were compared according to age,
gender, duration of diabetes, glycaemic control, risk factors,
previous surgery such as wound debridement or previous toe
amputation, vascular assessment and site of ulcer, reduction
in size of ulcer. The ulcers in both the groups were classified
according to the Wagener’s grading of ulcer classification. All data collected was entered into Microsoft Excel 2016 and
analysed using Statistical Package for the Social Sciences
(SPSS) version 16.0 (IBM SPSS, US) software. A p-value less
than 0.05 was considered as statistically significant.
Results: Among 44 patients, there was equal number of
males and females in both the groups, with the total mean age
53.97±10.10 years. The majority of the study population belonged
to the 5th decade (51-60 years), where the youngest patient was
of 29 years and oldest was of 72 years. There were 22 patients in
offloading group and 24 patients in conventional dressing group
as one patient had bilateral plantar ulcers and one patient had two
separate ulcers on the plantar aspect of the foot. Total of 45.45%
in conventional group and 31.82% of the study population in
offloading group had diabetes for 5-10 years of duration. Bad
glycaemic control was seen in 40.90% of offloading group and
50% in conventional group. The size reduction percentage of
ulcers on comparing both the groups was found to be significant
for 2nd week review (p-value=0.03) and was nearly significant for
the 6th week review (p-value=0.05).
Conclusion: Summarising the above conducted study,
offloading dressing was found to be a more efficacious
alternative to the conventional dressing as there was greater
difference observed in the reduction of the size of ulcer and
the patients in the conventional group needed more number of
dressings and the duration of healing in the two groups. |
first_indexed | 2024-04-10T22:24:14Z |
format | Article |
id | doaj.art-796e9c1d5a48466da200f3481e493a15 |
institution | Directory Open Access Journal |
issn | 2249-782X 0973-709X |
language | English |
last_indexed | 2024-04-10T22:24:14Z |
publishDate | 2022-10-01 |
publisher | JCDR Research and Publications Private Limited |
record_format | Article |
series | Journal of Clinical and Diagnostic Research |
spelling | doaj.art-796e9c1d5a48466da200f3481e493a152023-01-17T10:21:27ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-10-011610PC05PC1010.7860/JCDR/2022/49942.16999Comparison of Offloading Dressing with Conventional Dressing in Healing of Plantar Diabetic Foot Ulcers: A Randomised Clinical TrialShraddha Modi0T Tirou Aroul1Postgraduate, Department of General Surgery, Mahatma Gandhi Medical College and Research Institute, Gulbarga, Karnataka, India.Professor, Department of General Surgery, Mahatma Gandhi Medical College and Research Institute, Pillayarkuppam, ECR Cuddalore Road, Pondicherry, India.Introduction: The first ever description of Diabetic Foot Ulcers (DFUs), made in the literature was in the mid 19th century. The management principles for it were laid by late 19th century and are still being followed. For a chronic DFU to heal, offloading of pressure, surgical debridement, correction of hyperglycaemia, the use of antibiotics are the corner stone of management. Offloading is an essential modality of prevention and treatment of recurrent plantar DFU. Aim: To compare offloading dressing to conventional dressing in promoting healing of diabetic plantar foot ulcers. Materials and Methods: This randomised clinical trial was conducted at Mahatma Gandhi Medical College and Research Institute, Pondicherry, India, between January 2019 to June 2020 among the patients with DFU coming to the Department of General Surgery. A total of 44 patients were included in the study, 22 of these patients underwent offloading dressing and 22 underwent conventional dressing and these patients were followed-up for a duration of 6 weeks and compared on 2nd, 4th and 6th weeks. The patients were compared according to age, gender, duration of diabetes, glycaemic control, risk factors, previous surgery such as wound debridement or previous toe amputation, vascular assessment and site of ulcer, reduction in size of ulcer. The ulcers in both the groups were classified according to the Wagener’s grading of ulcer classification. All data collected was entered into Microsoft Excel 2016 and analysed using Statistical Package for the Social Sciences (SPSS) version 16.0 (IBM SPSS, US) software. A p-value less than 0.05 was considered as statistically significant. Results: Among 44 patients, there was equal number of males and females in both the groups, with the total mean age 53.97±10.10 years. The majority of the study population belonged to the 5th decade (51-60 years), where the youngest patient was of 29 years and oldest was of 72 years. There were 22 patients in offloading group and 24 patients in conventional dressing group as one patient had bilateral plantar ulcers and one patient had two separate ulcers on the plantar aspect of the foot. Total of 45.45% in conventional group and 31.82% of the study population in offloading group had diabetes for 5-10 years of duration. Bad glycaemic control was seen in 40.90% of offloading group and 50% in conventional group. The size reduction percentage of ulcers on comparing both the groups was found to be significant for 2nd week review (p-value=0.03) and was nearly significant for the 6th week review (p-value=0.05). Conclusion: Summarising the above conducted study, offloading dressing was found to be a more efficacious alternative to the conventional dressing as there was greater difference observed in the reduction of the size of ulcer and the patients in the conventional group needed more number of dressings and the duration of healing in the two groups.https://jcdr.net/articles/PDF/16999/49942_CE(AnK)_F(KR)_PF1(PS_OM)_PFA(SS)_PB(PS_SS)_PN(SS).pdfperipheral arterial diseaseshoe model casttotal contact cast |
spellingShingle | Shraddha Modi T Tirou Aroul Comparison of Offloading Dressing with Conventional Dressing in Healing of Plantar Diabetic Foot Ulcers: A Randomised Clinical Trial Journal of Clinical and Diagnostic Research peripheral arterial disease shoe model cast total contact cast |
title | Comparison of Offloading Dressing with Conventional Dressing in Healing of Plantar Diabetic Foot Ulcers: A Randomised Clinical Trial |
title_full | Comparison of Offloading Dressing with Conventional Dressing in Healing of Plantar Diabetic Foot Ulcers: A Randomised Clinical Trial |
title_fullStr | Comparison of Offloading Dressing with Conventional Dressing in Healing of Plantar Diabetic Foot Ulcers: A Randomised Clinical Trial |
title_full_unstemmed | Comparison of Offloading Dressing with Conventional Dressing in Healing of Plantar Diabetic Foot Ulcers: A Randomised Clinical Trial |
title_short | Comparison of Offloading Dressing with Conventional Dressing in Healing of Plantar Diabetic Foot Ulcers: A Randomised Clinical Trial |
title_sort | comparison of offloading dressing with conventional dressing in healing of plantar diabetic foot ulcers a randomised clinical trial |
topic | peripheral arterial disease shoe model cast total contact cast |
url | https://jcdr.net/articles/PDF/16999/49942_CE(AnK)_F(KR)_PF1(PS_OM)_PFA(SS)_PB(PS_SS)_PN(SS).pdf |
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