Effectiveness of Topical Sucralfate in the Management of Diabetic Foot Ulcers: An Open-Labeled Randomized Study.

INTRODUCTION: Diabetic foot ulcer (DFU) is a major cause of lower limb amputations. Many treatment recommendations have been proposed. This study was conducted to evaluate the effectiveness of topical sucralfate when combined with mupirocin ointment, in the treatment of diabetic foot ulcer in comparison to topical mupirocin alone, in terms of healing rates. METHODS: This open-labeled randomized study was conducted on 108 patients to evaluate the effectiveness of topical sucralfate and mupirocin combination, compared to topical mupirocin alone. The patients were administered the same parenteral antibiotic, and wounds were subjected to daily dressing. The healing rates (determined by the percentage reduction in wound area) in the two groups were calculated. The mean healing rates in both groups were expressed in percentage and compared using the Student's t-test. RESULTS: A total of 108 patients were included in the study. Male-to-female ratio was 3:1. The incidence of diabetic foot was the highest (50.9%) in the age group of 50-59 years. The mean age of the study population was 51 years. The incidence of diabetic foot ulcers was highest in the months of July-August (42%). A total of 71.2% patients had random blood sugar levels between 150-200 mg/dL, and 72.2% patients had diabetes for five to 10 years. The mean±standard deviation (SD) of the healing rates in the sucralfate and mupirocin combination group and the control group were 16.2±7.3% and 14.5±6.6%, respectively. Comparison of the means by Student's t-test failed to show a statistical difference in healing rates between the two groups (p=0.201). CONCLUSION: We concluded that the addition of topical sucralfate does not show any obvious benefits in terms of healing rates in diabetic foot ulcers as compared to mupirocin alone.

Mucinous cystadenoma of the appendix with enterocutaneous fistula: a therapeutic dilemma.

Mucinous cystadenoma of appendix is a rare clinical entity with very few reported cases in the literature. Consensus on optimal surgical management has not been reached. We report the case of a 65-year-old female patient who presented with fistula over the right iliac fossa. Computed tomography (CT) of the abdomen suggested abscess of the parietal wall. Upon exploration, a mass was found to be arising from the tip of the retroperitoneal appendix and the retroperitoneum was studded with mucoid material. Appendectomy was carried out and final histopathology revealed mucinous cystadenoma with no evidence of malignancy. The patient was discharged uneventfully. The unusual presentation of this disease, as retroperitoneal psuedomyxoma without any intraperitoneal pathology, prompted us to report this case.