Evaluation of the Antimicrobial Effect of Carboxymethyl Cellulose versus Silver with Saline Dressing in Diabetic Ulcers.

ABSTRACT

Background: The diabetic foot ulcer is a major complication of diabetes mellitus. (1) It occurs in 15% of all patients with diabetes and precedes 84% of all lower leg amputations. (2) Diabetes mellitus impedes wound healing by prolonging the inflammatory phase. Increased glucose in the tissue precipitates infection. (3) Diabetic microangiopathy which affects microcirculation. Increased glycosylated hemoglobin decreases the oxygen dissociation. Increased glycosylated tissue protein decreases the oxygen utilization. This study is intended to show the efficacy of carboxymethyl cellulose (CMC) dressing for a faster healing of diabetic ulcers when compared with the conventional saline dressing. Materials and Methods: This study was a prospective case–control comparative study conducted at the Department of General Surgery and Gastroenterology, father Muller Medical College, Mangalore, from August to July 2016. 80 consenting patients who met the predefined criteria were taken for the study and divided into two groups, 40 patients each is put in the CMC with silver dressing group and the conventional saline dressing group. Results: There was no statistically significant difference between the two groups in terms of gender, age, glycemic control, and site of ulcer P < 0.001. In our study, we found that there was statistically significant difference in the rate of infection between the two groups. Conclusion: Silver impregnate dressings have a role in the management of diabetic ulcers by reducing the local burden of infection which is an important cause for non-healing ulcer analgesia.