Topical phenytoin solution for treating pressure ulcers: a prospective, randomized, double-blind clinical trial

Area of Science:

• Dermatology
• Pharmacology
• Rehabilitation Medicine

Background:

• Pressure ulcers are a significant complication for patients with spinal cord disorders.
• Effective topical treatments are crucial for managing these debilitating wounds.
• Phenytoin, an anticonvulsant, has shown potential in wound healing.

Purpose of the Study:

• To assess the efficacy of topical phenytoin solution in healing pressure ulcers.
• To determine the systemic absorption of topical phenytoin in patients with spinal cord disorders.
• To evaluate the safety profile of topical phenytoin for pressure ulcer treatment.

Main Methods:

• A prospective, randomized, double-blind clinical trial was conducted.
• 28 patients with stage 2 pressure ulcers received either phenytoin solution or normal saline dressing daily for 15 days.
• Efficacy was measured by Pressure Ulcer Scores for Healing (PUSH 3.0), ulcer volume, and size. Serum phenytoin levels were monitored.

Main Results:

• Topical phenytoin showed a marginally greater reduction in PUSH 3.0 scores and ulcer size compared to normal saline, though not statistically significant.
• Systemic absorption of topical phenytoin was negligible.
• No adverse drug events were observed during the study period.

Conclusions:

• Topical phenytoin solution is a safe agent for treating pressure ulcers.
• The solution demonstrated a slight acceleration in pressure ulcer healing compared to normal saline.
• Further investigation is warranted to fully establish the clinical efficacy of topical phenytoin for pressure ulcer management.