COMPARATIVE EVALUATION OF SUPEROXIDE SOLUTION DRESSING AND POVIDONE-IODINE DRESSING IN THE MANAGEMENT OF WAGNER GRADE 3 AND GRADE 4 DIABETIC FOOT ULCERS

Abstract

Background: Diabetic foot ulcers are common limb-threatening complications of diabetes mellitus, and effective local wound dressings are essential to reduce infection, promote granulation, and accelerate healing.

Objectives: To comparatively evaluate the efficacy, safety, and cost-effectiveness of superoxide solution dressing versus povidone-iodine dressing in the management of diabetic foot ulcers.

Methods: This single-centre, hospital-based, prospective comparative study was conducted in the Department of General Surgery, Sree Balaji Medical College and Hospital, Chennai, over 18 months among patients with Wagner Grade 3 and Grade 4 diabetic foot ulcers. Patients were treated with either superoxide solution dressing or 10% povidone-iodine dressing.
Results: The two groups were comparable at baseline, with similar mean age (54.8 ± 12.3 vs 56.1 ± 13.4 years), type 2 diabetes prevalence (96.1% vs 98.0%), duration of diabetes (9.2 ± 3.8 vs 8.7 ± 3.5 years), initial ulcer area (39.0 ± 18.0 vs 39.8 ± 19.5 cm²), Wagner grade distribution, forefoot involvement, and purulent discharge. Initial cultures showed Pseudomonas aeruginosa as the commonest isolate in the superoxide group (23.5%) and Staphylococcus aureus in the povidone-iodine group (27.5%). Ulcer reduction was greater with superoxide dressing from Week 2 onward, reaching 72.3% versus 56.0% by Week 12. Mean ulcer-area reduction was significantly higher in the superoxide group (59.2 ± 6.1% vs 41.0 ± 8.4%; p=0.001). Superoxide dressing also showed better Day 10 bacterial clearance, earlier granulation, shorter hospital stay, higher complete healing, and fewer non-healing/amputation outcomes.

Conclusion: Superoxide solution dressing was more effective than povidone-iodine dressing in promoting ulcer-size reduction, early granulation, bacterial clearance, shorter hospital stay, and complete healing in patients with advanced diabetic foot ulcers.