Comparative Effectiveness of Extra-Corporeal Shock Wave Therapy, Platelet Rich Plasma Therapy and Topical Insulin Therapy in Diabetic Foot Ulcer Healing

RESUMO

Sally A EL-Leithy*, Nahla Nader Adly, Rana M Taha, Nermin H El- Gharbawy

Aim: to compare the effectiveness of shock wave therapy, platelet rich plasma injection (PRP) and topical insulin therapy on healing of diabetic foot ulcer.

Methods: Sixty type II diabetic nonsmoker male patients with diabetic foot ulcer were recruited. The patients were randomly divided into four groups. All groups received standard care treatment. Fifteen patients received shockwave therapy (Group1). Fifteen patients received PRP therapy (Group 2). Fifteen patients received topical insulin therapy (Group 3). Fifteen patients received standard care treatment only (Group 4). All patients were subjected to full history, general and local examination, also BMI, HbA1c were measured. PUSH score was assessed in all groups at zero, fourth and twelfth weeks.

Results: The four groups were matched as regards to age, BMI, HbA1c, and PUSH scores at zero weeks. There was statistically high significant decrease in the mean value of PUSH score at fourth and twelfth weeks of follow up compared to zero weeks in the four groups. At fourth and twelfth weeks of follow up there was statistically highly significant decrease in the mean value of PUSH score of Group 3 who received topical insulin compared to other groups. There was statistically significant correlation between PUSH score and each of BMI and HbA1c.

Conclusion: Diabetic foot ulcer in people with diabetes is common. Occurrence of ulceration, infection and gangrene are the most common causes of hospitalization. Appropriate and prompt management is necessary for successful treatment of DFU.