Microbiologic Profile of Diabetic Foot Ulcers: A Trial of Honey Versus Povidone Iodine Dressings

Abstract

Diabetic foot ulcers (DFU), a debilitating complication of diabetes mellitus, are often infected. Infections impede wound healing and can lead to ulcer progression and possible mortality if poorly managed. Wound dressing is vital to DFU management, and supports the prevention and treatment of wound infections. Aims: To compare the effect of honey and povidone iodine dressings on wound microbial colonization and infection for Wagner Grade 2 DFU. Study Design:  This was a randomized controlled trial on the effects of honey and povidone iodine dressings on the microbiologic profile of Wagner grade 2 DFU at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, spanning a year interval. Methodology: Thirty patients (13 females) aged 47 to 65 years with Wagner grade 2 diabetic foot ulcers were enrolled. Data on socio-demographics, and contaminating/infecting organisms were obtained from serial swab sample collection and microbiological investigation and analysed using Statistical Package for the Social Sciences (SPSS) 20.0. A p-value < 0.05 was considered significant. Results: The mean HbA1c levels were 7.52±1.023% and 7.40±0.944% for the honey and povidone iodine groups respectively (P =0.73). Staphylococcus aureus, Escherichia.coli, Pseudomonas, Klebsiella, Proteus spp. were all cultured at baseline studies. S. aureus was the most prevalent throughout the study duration. By week 4, none of the patients in the honey grouphad organisms isolated. By week 5 and 6, no microbial organism was isolated from the patients in both groups. Conclusion: Polymicrobial ulcer contamination occurs commonly in DFU. Optimal wound care controls microbial activity, thereby promoting wound healing.