Comparative Study of Topical Application of Platelet-Rich Plasma and Phenytoin in Healing Diabetic Foot Ulcers in Rats

Abstract

Diabetic Foot Ulcer (DFU) is a major complication of diabetes with alarming rates of morbidity and mortality. Despite the wide range of treatments, treating DFU remains a medical challenge. From these therapies is Platelet Rich Plasma (PRP) and Phenytoin cream. This study aimed to compare the wound healing efficacy of PRP gel and 1% Phenytoin cream in a rat model of DFU. 24 male Albino rats were randomly divided into two main groups, control (n=6) and diabetic (n=18). In diabetic group, diabetes was induced by a High Fat Diet for 28 days followed by a single dose of 40 mg/kg Streptozotocin. On day 42, neuropathy was assessed then a wound was induced on the right hind paw of each rat. Infection was assessed on day 46 and gentamicin was applied on wounds for 14 days. On day 60, the diabetic group was sub-classed into three sub-groups; untreated diabetic wounded group (DW), diabetic wounded treated with 1% Phenytoin cream group (DW Phen) and diabetic wounded treated with PRP gel group (DW PRP). Treatment regimen was applied as directed and images of wounds were taken on days 0,4,7,10,14,17,22 and 24 of treatment and wound measurements were recorded. On day 10,17 and 24 of treatment, two rats from each group were taken for euthanasia and DFU sections were obtained for histopathological and immunohistochemical studies. The findings of this study concluded the efficacy of both DW PRP and DW Phen in treating DFU in the rat model by starting complete contraction from day 14 for DW PRP and day 17 for DW Phen. Histological observation showed progressive re-epithelization with collagen deposition in PRP. Immunohistochemistry revealed advanced neo-vessel in both DW PRP and DW Phen groups.