Article
EUSOL® Versus Antibiotic Loaded Collagen Granules (Co-Mupimet®) as a Dressing Agent in the Management of Traumatic Wounds
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Published: | October 23, 2017 |
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Objectives: Traumatic wounds are one of the common causes of morbidity in orthopaedic patients. To this date there is no RCT available that compares the healing potential of Edinburgh University Solution of Lime (EUSOL) with mupirocin in collagen granules and Metronidazole (Co-Mupimet®) as dressing agent. We aim to compare the effectiveness and healing potential of Co-Mupimet® and EUSOL in terms of quantity and quality of granulation tissue formation, pattern of wound discharge, healing potential or need of secondary procedures like skin grafting or flap coverage.
Methods: 130 eligible patients with infected traumatic limb wounds and surgical infected wounds were randomized into EUSOL group (n=65) and Co-Mupimet® group (n=65). Patients with impaired wound healing potential, wound over insensate/avascular limb and patients not giving consent were excluded. A wound swab for culture was taken for all cases at the presentation. Size of wound after debridement at initial presentation, at 1st, 2nd, 3rd and 4th week was measured as well as quality and quantity of granulation tissue formation was assessed.
Results and Conclusion: The gender distribution (p=0.323), mode of injury distribution (p=0.826), spectrum of injury (p=0.31) and ratio of culture positives at presentation (p=0.71) among the groups were not significant. The mean age (yrs.), mean wound size at presentation after debridement (cm2), baseline haemoglobin (gm/dl), random blood sugar (mg/dl) and serum albumin (gm/dl) was 35.11±20.63, 36.08±28.98, 10.78±1.79, 97.76±15.27 and 5.90±0.84 respectively for EUSOL group while it was 34.56±19.58, 37.77± 36.97, 10.88±1.63, 95.52±12.64 and 5.96±0.70 respectively for Co-Mupimet® group (p-values >0.05). The p-value for ratio of discharging wounds among the EUSOL group and Co-Mupimet® groups at 1st, 2nd, 3rd and 4th week was 0.20, 0.62, 0.54 and 0.24 respectively. Lesser amount of discharge was seen among wounds dressed with collagen granules (p>0.05). Similarly, the p-value for appearance of healthy granulation tissue among the groups at 1st, 2nd and 3rd week were 0.02, 0.00 and 0.02 respectively. Probability of complete healing at 1st, 2nd, 3rd and 4th week were 0.16, 0.29, 0.41 and 0.50 respectively for EUSOL group while they were 0.26, 0.61, 0.61 and 0.40 respectively for Co-Mupimet® group with their corresponding Odds ratio as 1.62, 2.10, 1.48 and 0.80 respectively.
Co-Mupimet® is a better and cost-effective dressing agent as it showed earlier and higher probability of healing with better quality granulation tissue which is ready for skin grafting much earlier. This indirectly cuts-off the hospital stay/treatment cost and use of hospital resources.