A comparison of topical honey and phenytoin in the treatment of chronic leg ulcers

Abstract

In view of the reports that phenytoin and honey are useful in the healing of wounds, a comparison of their topical use in the treatment of chronic leg ulcers was carried out. Fifty cases of chronic leg ulceration were studied, each for a period of four weeks. They were assigned into three groups for honey, phenytoin/honey mixture, and phenytoin topical treatment. Overall mean duration of the ulcers was 56.5 months while the mean(s.d.) size was 3339 (5193) mm2. Mean percent reduction in size in the group treated with honey, 27.0 (36.9), was not significantly different (H=0.26; 2 df; p=0.88) from that of the mixture group, which was 25.9(46.4), and from that of the phenytoin group which was 35.5(53.2). This percent reduction in size was significantly greater, (H=7.69; 2df; P = 0.02), during the first week in the phenytoin group than in the other groups. Four of the cases progressed to complete healing at the end of four weeks with phenytoin. Pain score difference (using a graduation scale from 0 to 10) at the end of the four-week treatment, was, 1.8 (1.7) in honey group, 2.0 (1.3) in mixture group and 3.6 (2.4) in phenytoin group. This difference was not significant, (H=3.09; 2df; P = 0.21). Our study suggests that phenytoin may be superior to honey as a topical agent in the treatment of chronic ulcers.