A Randomized Trial of Honey Versus Povidone Iodine Dressings: Pain Profile of Wagner Grade 2 Diabetic Foot Ulcers

Abstract

Diabetic foot ulcers (DFU), a chronic disorder of public health importance arise from pathologic changes following abnormal glucose metabolism. Wound dressing is vital to DFU management and is designed to promote healing and relieve pain among other roles. Pain associated with chronic wounds can delay healing, reduce quality of life, and affect mental health. This study evaluates the effect of honey and povidone iodine-based dressings on the severity of pain associated with Wagner grade 2 DFU. Study Design:  This was a randomized controlled trial on the pain-modulating effects of honey and povidone iodine dressings on Wagner grade 2 DFU using the visual analogue scale (VAS) at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt over a year duration. Methodology: We included 30 patients (17 males; age range 47-65 years) with Wagner grade 2 diabetic foot ulcers. Data on socio-demographics, BMI, HbA1c, ulcer etiology and site distribution, VAS for pain intensity, wound exudate characteristics and extent of healing were obtained and analyzed using Statistical Package for the Social Sciences (SPSS) 20.0. A p-value <0.05 was considered significant. Results: The median VAS pain score was 2.0 and 3.0 for the honey and povidone iodine dressing groups respectively (p-value=0.724) in week 1, then 1.0 and 2.0 for the honey and povidone iodine dressing groups respectively and (p-value=0.041) in week 3. By week 5, all ulcers in the honey group were healed, and the lone persistent ulcer in the povidone group had a 1.0 VAS score by week 6. Conclusion: Honey dressings are associated with less wound pain over the course of treatment compared to povidone iodine dressing in the treatment of Wagner 2 DFU.