A Comparative study of Effectiveness between Topical Diperoxochloric acid versus Normal Saline dressings in Management of Diabetic Foot Ulcers

Abstract

Background: Diabetic foot ulcers (DFU) are a common and severe complication of diabetes, often leading to prolonged morbidity and risk of amputation. Effective wound care strategies, including topical agents, are essential to promote healing and prevent complications.

Objectives: To compare the effectiveness of topical Diperoxochloric acid and normal saline dressings in managing DFU; and to evaluate the specific efficacy of Diperoxochloric acid in promoting ulcer healing.

Methods: This was a single centre, hospital based, prospective, randomized controlled trail conducted in the Department of General Surgery, JSS Medical College, Karnataka, India for a duration of 18 months.

Results: Baseline characteristics including age, gender, comorbidities, BMI, smoking status, haemoglobin, HbA1C, and wound culture results were statistically comparable between the topical Diperoxochloric acid dressings (TDCA) and normal saline dressings (NS) groups (N = 71 in each group). Ulcer size reduction was significantly greater in the TDCA group, with a mean surface area of 3.8 cm² at Week 2 compared to 4.9 cm² in the NS group (p = 0.001), and the percentage reduction in ulcer surface area was markedly higher in the TDCA group (40.4%) than in the NS group (11.2%; p = 0.002). Granulation tissue formation was significantly more frequent in the TDCA group, observed in 73.2% by Week 2 versus 40.8% in the NS group (p < 0.001), indicating faster wound healing progression. The mean BWAT score decreased significantly in the TDCA group to 26.6 by Week 2 compared to 33.5 in the NS group (p < 0.001), reflecting superior wound improvement. Additionally, adverse events were lower in the TDCA group (23.9%) than in the NS group (47.9%; p = 0.005), with notably fewer wound infections (1.4% vs. 14.1%; p = 0.008).

Conclusion: Topical Diperoxochloric acid was found to be significantly more effective than normal saline in enhancing wound healing in DFU. It offers superior outcomes in terms of ulcer size reduction, granulation tissue formation, and infection control.