title: Wound bed preparation with 10-percent phenytoin ointment increases the take of split-thickness skin graft in large diabetic ulcers.
abstract: Healing of large diabetic foot ulcers may be difficult, particularly if the blood supply and chronic infection do not allow primary suturing. Split-thickness skin graft is a simple reconstructive technique used to close large wounds. Phenytoin is known to promote healing mainly by increasing granulation tissue formation. The effectiveness of topical phenytoin in wound-bed preparation (WBP) for split thickness skin grafting has been examined in 16 patients with large diabetic foot ulcers. All patients were treated with standard wound bed preparation including debridement of necrotic tissue. Topical phenytoin (10 % w/w ointment) was applied for 2-8 weeks prior to performance of autografting. Clinical and histologic evaluations were performed. The graft survival was 100 percent In twelve patients, 80-90 percent in three patients take and 60 percent in one patient. Neither local nor systemic side effects were observed. The authors conclude that phenytoin ointment is a safe and efficacious treatment to enhance the survival of split-thickness skin grafts in large chronic diabetic ulcers.
authors.affiliation: Department of Surgery and Faculty of Medicine, University of Jordan. niyounes@ju.ed
authors.forename: Nidal
authors.initials: N
authors.lastname: Younes
authors.forename: Abla
authors.initials: A
authors.lastname: Albsoul
authors.forename: Darwish
authors.initials: D
authors.lastname: Badran
authors.forename: Salwan
authors.initials: S
authors.lastname: Obedi
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D003131:Combined Modality Therapy; D003646:Debridement; D017719:Diabetic Foot / Q000150:complications* / Q000601:surgery; D004341:Drug Evaluation; D005260:Female; D016523:Foot Ulcer / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D006085:Graft Survival / Q000187:drug effects*; D006097:Granulation Tissue / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010672:Phenytoin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D016038:Skin Transplantation; D014182:Transplantation, Autologous; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D009824:Ointments; D010672:Phenytoin