Edinburgh University Solution of Lime (EUSOL) Versus Platelet-Derived Growth Factor Dressing for Wound Contraction in...

Background Diabetic foot ulcers remain a leading cause of lower-limb amputation worldwide, and wound management is especially difficult in resource-limited settings where older antiseptic agents such as Edinburgh University Solution of Lime (EUSOL) are still in routine use. This trial compared EUSOL dressing with platelet-derived growth factor (PDGF) dressing for wound contraction in Grade II Wagner diabetic foot ulcers. Methodology In this randomized controlled trial, 120 patients aged 30 to 70 years with Grade II Wagner diabetic foot ulcers were assigned in a 1:1 ratio to daily EUSOL dressing or PDGF dressing applied every fourth day for four weeks after debridement and infection control. Wound healing was defined as a reduction in ulcer area of at least 50% from baseline at four weeks. A multivariate logistic regression model examined treatment group, age, sex, body mass index (BMI), diabetes duration, and antidiabetic therapy as predictors of healing. Results Patients averaged 49.8 ± 10.2 years of age and a BMI of 27.1 ± 3.45 kg/m²; 58.3% were male. Seventy-eight patients (65%) used oral hypoglycemic agents alone, while 42 (35%) required insulin. Seventy-one patients (59.2%) had diabetes for more than 10 years. Wound contraction occurred in 20 of 60 (33.3%) patients on EUSOL versus 44 of 60 (73.3%) on PDGF (P < 0.001). PDGF remained a strong independent predictor of healing on multivariate analysis (adjusted odds ratio (OR) 6.14, 95% confidence interval (CI) 2.69-14.02, P < 0.001), as did insulin therapy (adjusted OR 2.48, 95% CI 1.10-5.59, P = 0.028). Conclusions PDGF dressing produced substantially better wound contraction than EUSOL in Grade II diabetic foot ulcers, an effect that persisted after adjustment for the usual confounders. Insulin use was independently linked to better healing, pointing to glycemic management as a modifiable lever alongside dressing choice. Confirmation in multicenter trials with longer follow-up, blinded outcome assessment, and cost data would strengthen the case for wider adoption of PDGF-based dressings in similar settings.