TOPICAL PHENYTOIN IN WOUND-HEALING

Background. Phenytoin, introduced in 1937 as an antiseizure medication, has since been reported to promote wound healing when applied as a topical agent. This study was undertaken to evaluate its effectiveness in chronic skin ulcers. Methods. Seventy-five inpatients with chronic skin ulcers were included in this controlled trial. Forty patients were treated with topical phenytoin, and 35 patients with conventional saline dressings. Assessment of the wounds included wound area, bacteriologic cultures, and clinical assessment by blind observers at baseline and every 7 days thereafter over the 4-week treatment period. Results. Wound area reduction was greater in the phenytoin group than in controls. Fifty percent of phenytoin-treated wounds had negative cultures by day 7, compared to 17% of controls. Healthy granulation tissue appeared earlier with phenytoin. At the end of the fourth week, 29 of 40 phenytoin-treated ulcers had healed completely versus 10 of 35 controls. Conclusions. Topical phenytoin appears to be an effective, inexpensive, and widely available therapeutic agent in wound healing. Further clinical use and evaluation is merited.