Efficacy of Topical Phenytoin versus Povidone-Iodine in the Treatment of Contaminated Traumatic Wounds among Patients Attending Jinja Regional Referral Hospital
Gilbert Simon Victor Niaina Ranaivoarijaona*1, Vivian Valin Akello1, Anthony Olasinde1, Reuben S. Maghembe2, Okuku Dakan Maxwel1 and Godfery Peter Edrine3
1Department of Surgery, Kampala International University Western Campus, Bushenyi, Uganda
2Department of Microbiology and Immunology, Kampala International University, Uganda
3Department of Accident and Emergency, Jinja Regional Referral Hospital, Uganda
*Corresponding author: Dr. Niaina Ranaivoarijaona Gilbert Simon Victor
Emails: niaina.sim23@gmail.com
ABSTRACT
In Uganda, like in other African countries, wound care is a significant health burden and a leading cause of hospital visits. Povidone iodine has been widely used for wound healing over the past century, while the efficacy of topical phenytoin has also been explored in various wound types, including traumatic wounds. This study aims to compare the efficacy of topical phenytoin versus povidone-iodine (PVP-I) in the treatment of traumatic wounds. This open-label trial was conducted in Eastern Uganda (August 2023 to January 2024) and included 88 patients with full-thickness contaminated traumatic wounds. Patients were randomly assigned to either topical phenytoin or PVP-I group using block randomization. Infection eradication, pain alleviation, and rate of granulation tissue formation were evaluated over 14 days using wound cultures, VAS score before treatment, and imitoMeasure smartphone application. Staphylococcus aureus was the most predominant organism isolated. On days 7 and 14, the phenytoin group showed a much lower positive culture compared with the PVP-I group with 7 out of 44 (15.9%) vs 14 out of 44 (31.8%) (p-value of 0.08 > 0.05) and 2 out of 44 (4.5%) vs 7 out of 44 (15.9%) (p-value of 0.079 > 0.05) respectively. The mean VAS score on days 7, and 14 were 3.8 ± 0.4 vs. 6.0 ± 1.0, and 2.6 ± 0.5 vs. 3.7 ± 0.6 in phenytoin group vs. PVP-I group 7 respectively (p < 0.0001). At Day 7 and 14, the mean percentage of granulation tissue formation was significantly higher in phenytoin group vs. PVP-I with 72.9% (SD = 7.3, 95% CI: 70.7-75.2) vs. 57.4% (SD = 4.30, 95% CI: 56.1-58.7) and 86.2% (SD = 7.2, 95% CI: 84.0-88.4) vs. 67.4% (SD = 4.4, 95% CI: 66.0 – 68.7) respectively (p < 0.0001). Topical phenytoin showed superior outcomes in pain reduction and granulation tissue formation compared to povidone-iodine. However, no significant difference was observed in antibacterial activity between the groups. Topical phenytoin is recommended as an alternative to povidone-iodine for treating contaminated traumatic wounds.
Keywords: Contaminated Traumatic Wound, Secondary intention, Granulation tissue, Topical phenytoin, Povidone Iodine, Eastern Uganda
CITE AS: Gilbert Simon Victor Niaina Ranaivoarijaona, Vivian Valin Akello, Anthony Olasinde, Reuben S. Maghembe, Okuku Dakan Maxwel and Godfery Peter Edrine (2025). Efficacy of Topical Phenytoin versus Povidone-Iodine in the Treatment of Contaminated Traumatic Wounds among Patients Attending Jinja Regional Referral Hospital. NEWPORT INTERNATIONAL JOURNAL OF SCIENTIFIC AND EXPERIMENTAL SCIENCES 6(1):70-77. https://doi.org/10.59298/NIJSES/2025/61.707700