Comparative study between mandakini off-loading and conventional gauze dressing in the management of diabetic foot plantar ulcers

Abstract

Background: Diabetic foot ulcers (DFUs) are a major complication of diabetes mellitus and a leading cause of morbidity, hospitalization, and lower-limb amputation. Effective off-loading is essential for optimal wound healing, but conventional methods remain costly, complex, and less patient-friendly in resource-limited settings.

Aim: To compare the clinical efficacy of Mandakini off-loading dressing with conventional gauze dressing in the management of diabetic plantar foot ulcers.

Materials and Methods: This prospective comparative study was conducted over 18 months at Navodaya Medical College Hospital and Research Centre, Raichur. A total of 154 patients with Wagner grade 1 and 2 plantar DFUs were enrolled and divided into two groups of 76 each. Group A received Mandakini off-loading dressing, while Group B received conventional wet gauze dressing. Outcomes assessed included wound healing time, wound size reduction, granulation tissue formation, infection rate, recurrence, and amputation rate. Statistical analysis was performed using SPSS version 25, with p < 0.05 considered significant.

Results: Baseline characteristics were comparable between both groups. Mean healing time was significantly shorter in Group A (4.3 ± 1.1 weeks) compared to Group B (5.8 ± 1.3 weeks) (p < 0.001). Infection rate (13.2% vs 28.9%) and ulcer recurrence (7.9% vs 21.1%) were significantly lower in Group A. Wound contraction and granulation tissue formation were also significantly better in the Mandakini group (p < 0.001). Although amputation rates were lower in Group A (2.6% vs 7.9%), the difference was not statistically significant.

Conclusion: Mandakini off-loading dressing is a simple, cost-effective, and clinically superior alternative to conventional gauze dressing, providing faster healing and better overall outcomes in diabetic plantar ulcers.