Comparative Evaluation of Rifampicin Powder Dressing versus Betadine Dressing in Lower Limb Ulcers Using the Bates-Jensen Wound Assessment Tool (BWAT): A Prospective Randomized Controlled Study1st author

Abstract

Introduction: Ulcer is defined as breech in epithelium or mucosa. Lower limb ulcers are most commonly due to venous, arterial or neuropathic causes. Most commonly in India the lower ulcers are due to a venous pathology whereas in JSS hospital the most common cause of lower ulcers was found to be diabetes mellitus.

Objectives: To assess wound healing of lower limb ulcers in patients treated with local application of rifampicin powder dressing using BATES-JENSEN Wound Assessment Tool (BWAT) at 3, 5.

Methodology: This study is a prospective interventional randomized control study which was conducted over a period of 18 months, with 100 patients participating in the study amongst which 50 patients underwent betadine dressing (Group A) and 50 patients underwent rifampicin dressing (Group B). After patient have been selected the ulcer will be scored according to BWAT score and that will be considered the baseline score of the ulcer. Under sterile precautions the ulcer will be cleaned and thorough debridement will be done. Rifampicin 150mg capsules containing rifampicin powder will be used for the local application over the ulcer.

Results: The study showed significant decrease in size of the ulcer, decrease in exudate amount, peripheral tissue edema and induration in patients treated with rifampicin dressing when compared with ulcers treated with betadine dressing. There was also significant increase in granulation tissue for the ulcers treated with rifampicin dressing. 52% patients who underwent rifampicin dressing were found have no growth in the pus culture implying reduction in bacterial load of the ulcer.

Conclusion: Rifampicin is a cheap drug which is easily available all over India. Local application of rifampicin is an easy method of local antibiotic application to treat the lower limb ulcers to hasten the process of wound healing and decrease the need for debridement and prepare the ulcers earlier for SSG.