Comparative study of Papaya Vs Normal Saline Dressing in healing of Ulcers

AIM OF THE STUDY: 1. To compare the effectiveness of papaya and normal saline in healing of ulcers. 2. To evaluate the role of papaya dressing in wound debridement, granulation tissue formation, reduction in ulcer size and ulcer healing. BACKGROUND: Wet to dry normal saline mechanical debridement is the most common, cost effective debridement method which is used widely, in our hospital setup also in management of wound care. Papaya has been a enzymatic debriding agent which is in use for many years. There has been various review articles and studies on the debriding properties of papaya in western population and diabetic rats. This study was conducted to compare the efficacy of two debriding agents : enzymatic debridement with papaya and wet to dry normal saline mechanical debridement on diabetic wounds, sloughed infected wounds and in post operative wound dehiscence. MATERIALS AND METHODS: This is a comparative interventional study of 100 patients done at Government Kilpauk Medical College Hospital, Chennai between August 2013 to August 2014. patients were selected and randomized into two groups Group I – treated with papaya and Group II with normal saline. Patients were clinically assessed at the time of inclusion and daily dressing was done. Patients were assessed weekly for 4 weeks and response noted regarding slough reduction, granulation tissue formation, reduction in ulcer size and overall response to treatment. Additional treatment and follow up upto 3 months were recorded. RESULTS: Papaya is a better and efficacious debriding agent in comparison to wet to dry normal saline dressing and it also promotes faster granulation tissue formation. Overall response to treatment with papaya is good. CONCLUSION: Papaya dressing and normal saline dressing have proven efficacy in debridement of wounds. Papaya dressing is a better enzymatic agent when compared to wet to dry normal saline mechanical debridement. Papaya dressing was found to remove slough and necrotic tissue more rapidly when compared to normal saline as per our study. Wounds treated with papaya dressing had a faster granulation tissue formation compared to normal saline dressing. There was no significant difference in reduction in ulcer size between the two groups in this study. Overall response to treatment with papaya dressing was significantly better when compared to normal saline dressing