Comparative study on the Efficacy of Ionised Silver Solution Dressing with Conventional Dressing in Diabetic Foot Ulcers

INTRODUCTION: Diabetes mellitus virtually affects every organ system in the body and it can be well said that “Knowing diabetes, is like knowing the entire human body”. The ancient physician, Aretaeus of Cappadocia (81- 138 AD) in present Turkey was the first to use the term diabetes. Diabetes is a Greek word which signifies “siphon”. In 1920, Fredrick Banting, Charles Best and John James McLeod first isolated insulin from the pancreas and named it “Isletin”. The world experiencing a pandemic of Diabetes Mellitus, particularly of type 2. The magnitude of the problem of diabetes is enormous. By 2030, there will be 366 million diabetics in the world, which is mainly due to longer life expectancy and change in dietary habits. in future there will be a largest number of diabetics. One of the major complication associated with diabetes mellitus is diabetic foot. In present situation deep infection, abscess or ulcer developed in 3 to 4% of the diabetic patients. If they left untreated, it ends in amputation of the foot. 85% of the amputation done because of non traumatic cause is mainly due to diabetic foot. It gives you a staggering load to provide an organized foot care services. AIM AND OBJECTIVES: To study the efficacy of ionized silver solution dressing in the management of diabetic foot ulcer in comparison with conventional. wound dressing. Ulcer is assessed at the baseline, 3 week and 5 weeks and look for a) Overall reduction in ulcer size, b) Length of the hospital stay, c) Number of dressings required. STUDY DESIGN: Prospective and Comparative study. PLACE OF STUDY: Govt. Kilpauk Medical College Hospital, Chennai. MATERIAL AND METHODS: 50 patients will be divided into two groups: Conventional dressing group and silver dressing group. Conventional dressings group will be managed with debridement and povidone iodine dressings. Silver dressing group with debridement and application of ionic silver solution dressing. Ulcer is assessed at the baseline, 3 weeks and 5 weeks to measure overall healing rate, number of dressings needed and length of the hospital stay. RESULTS: Average duration of hospital stay is 2- 3 weeks in silver dressing group and in conventional dressing group a patient stay for 4-5 weeks and P value < 0.05 and is highly significant. Percentage reduction of ulcer is between 81-99% in 76%patients of silver solution dressing group. While only 20% patients in conventional dressing group. P value is < 0.001 and is highly significant. Number of dressings required per patient is 11 in silver dressing group and is 18 in conventional dressing group, P value < 0.001 and is significant. CONCLUSION: Ionic silver dressings are safe, effective, with a beneficial edge to the conventional dressing with solutions like povidone iodine in terms of promoting wound healing, and are more patient compliant in view of overall reduction in the ulcer size, Less number of dressings required, Less duration of hospital stay