Gupta Shubham, Shinde Raju K, Shinde Sangita
General Surgery, Datta Meghe Institute of Medical Sciences, Deemed to be University, Wardha, IND.
Pharmacology, Datta Meghe Institute of Medical Sciences, Deemed to be University, Wardha, IND.
Cureus. 2022 May 2;14(5):e24667. doi: 10.7759/cureus.24667. eCollection 2022 May.
Background In this era of upcoming newer formulations of topical ointments in the market, selecting an appropriate topical ointment for managing ulcers is challenging with regards to granulation tissue promotion, ulcer size reduction, and decrease in the amount of discharge from the ulcer. This study compares the outcomes of two topical iodine formulations, namely, cadexomer iodine ointment (0.9%) and povidone-iodine ointment (5%), for the management of various types of ulcers. Methodology This prospective, interventional study was conducted in a tertiary care hospital. After screening, 40 patients with ulcers (venous, arterial, diabetic, traumatic, infective) were subjected to simple randomization based on computer-generated random numbers at a ratio of 1:1 for the application of cadexomer (n = 20) (Group A) and povidone-iodine ointment (n = 20) (Group B). Selected patients were subjected to broad-spectrum antibiotics on admission and then shifted to special antibiotics based on the culture and sensitivity report of the wound. The application of these two formulations was done in three settings, each lasting 48 hours. The efficacy of these two formulations was assessed based on the following three parameters: (a) the percentage of granulation tissue promotion, (b) wound size reduction, and (c) decline in wound discharge. The study groups were compared using an unpaired t-test, while the association among the study groups was performed using Fishers' test, Student's t-test, and chi-square test. P-values less than 0.05 were considered significant. Results Significant improvement (p < 0.05) in granulation tissue was observed with cadexomer ointment application compared to povidone-iodine ointment. Statistically significant reductions in ulcer size and discharge from ulcers were seen in both groups; however, clinically, cadexomer ointment was found to be more effective compared to povidone-iodine ointment in reducing ulcer size as well as in reducing the amount of discharge from ulcers. Conclusions Cadexomer iodine ointment proved to be better than povidone-iodine ointment in the management of ulcers regarding the percentage of granulation tissue promotion, ulcer size reduction, and decrease in the amount of discharge from ulcers.
背景 在市场上即将出现新型外用软膏制剂的这个时代，选择一种合适的外用软膏来治疗溃疡在促进肉芽组织生长、减小溃疡大小以及减少溃疡渗出量方面具有挑战性。本研究比较了两种外用碘制剂，即卡地姆碘软膏（0.9%）和聚维酮碘软膏（5%）治疗各种类型溃疡的效果。
方法 这项前瞻性干预研究在一家三级护理医院进行。筛选后，40例溃疡患者（静脉性、动脉性、糖尿病性、创伤性、感染性）根据计算机生成的随机数字以1:1的比例进行简单随机分组，分别应用卡地姆碘（n = 20）（A组）和聚维酮碘软膏（n = 20）（B组）。入选患者入院时接受广谱抗生素治疗，然后根据伤口的培养和药敏报告改用特殊抗生素。这两种制剂在三个阶段使用，每个阶段持续48小时。根据以下三个参数评估这两种制剂的疗效：（a）肉芽组织促进百分比，（b）伤口大小减小情况，（c）伤口渗出减少情况。研究组之间的比较采用不成对t检验，而研究组之间的相关性采用费舍尔检验、学生t检验和卡方检验。P值小于0.05被认为具有统计学意义。
结果 与聚维酮碘软膏相比，应用卡地姆碘软膏观察到肉芽组织有显著改善（p < 0.05）。两组溃疡大小和溃疡渗出均有统计学意义的降低；然而，临床上发现卡地姆碘软膏在减小溃疡大小以及减少溃疡渗出量方面比聚维酮碘软膏更有效。
结论 在促进肉芽组织生长百分比、减小溃疡大小以及减少溃疡渗出量方面，卡地姆碘软膏在溃疡治疗中被证明比聚维酮碘软膏更好。
