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Research Paper | Surgery | India | Volume 13 Issue 11, November 2024 | Popularity: 5.4 / 10

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To Assess Wound Healing of Lower Limb Ulcers in Patients Treated with Local Application of Collagen Particles with Mupirocin and Metronidazole Powder Dressing

Prajwal P, Lohith A H, Chethan R, Karthik N

Abstract: An ulcer is defined as a breach in the continuity of epithelium or mucosa characterized by destruction of the surface epithelium and a granulating base. Lower limb ulcers are most commonly due to neuropathic, venous, or arterial causes. Most commonly in India, the lower limb ulcers are due to a venous pathology whereas in Karnataka the most common cause of lower limb ulcers was found to be diabetes mellitus. Various factors affect wound healing which include immunosuppression, co - morbidities, presence of foreign body, lack of hygiene, lack of knowledge, delayed hospital visits, infection, etc. Chronicity of wounds occurs due to persistence of infection. Hence treatment for such ulcers focuses on treatment of infection with antibiotics. This study aims to assess use of local application of collagen particles with mupirocin and metronidazole powder over the ulcers for wound healing and thus to assess the decrease in pus culture reports post - treatment with collagen particles with mupirocin and metronidazole. There is a need to explore the different moralities available for the treatment of diabetic foot, as it is the leading cause of lower limb ulcers in the locality. It not only affects the individual but the family associated too. Chronicity leads to financial burden, psychological problems and dependency. Hence treating them earliest aids in improvement in all aspects. Materials and Methods: This study is a prospective comparative study that was conducted over 6 months, with 50 patients participating in the study amongst which 25 patients underwent betadine dressing (Group A) and 25 patients underwent collagen particles with mupirocin and metronidazole dressing (Group B). After the patient was selected, the ulcer was scored according to BWAT score (? Bates ? Jensen Wound assessment tool) and considered the ulcer's baseline score. Under sterile precautions, the ulcer was cleaned and thorough debridement will be done. Daily such dressings was done and the ulcer healing was assessed on 3rd, 5th, and 7th day using BWAT scoring system. Culture swabs was taken from ulcers site of individuals in groups A and B on day 8. Results: The study showed a significant decrease in size of the ulcer, in exudate amount, in peripheral tissue edema and induration in patients treated with Collagen particles with mupirocin and metronidazole dressing compared to ulcers treated with betadine dressing. There was also significant increase in granulation tissue for the ulcers treated with Collagen particles with mupirocin and metronidazole dressing.52% patients who underwent Collagen particles with mupirocin and metronidazole dressing were found have no growth in the pus culture implying reduction in bacterial load of the ulcer. Also 12 patients (48%) underwent split skin grafting within 1 month of Collagen particles with mupirocin and metronidazole dressing. Conclusion: Collagen particles with mupirocin and metronidazole is a cheap local antibiotic which is easily available all over India. Local application of Collagen particles with mupirocin and metronidazole is an easy method of local antibiotic application to treat lower limb ulcers to hasten the process of wound healing and decrease the need for debridement and prepare the ulcers earlier for Split split - thickness skin Grafting.

Keywords: Lower limb ulcers, Diabetic foot, chronic non - healing ulcer, BWAT scoring, Collagen particles, Mupirocin, metronidazole

Edition: Volume 13 Issue 11, November 2024

Pages: 1094 - 1098

DOI: https://www.doi.org/10.21275/SR241118183203

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