Comparative Study on Metrogyl Dressing Versus Povidone Iodine Dressing Among Patients Presenting With Diabetic Foot Ulcers in Tertiary Care Hospitals.

Background Diabetic foot ulcers (DFUs) are a major complication of diabetes, posing significant challenges due to impaired wound healing, increased infection risk, and frequent need for surgical intervention. Optimal wound care is essential to reduce morbidity, hospital stay, and healthcare costs. While povidone iodine is a common antiseptic dressing, Metrogyl (metronidazole) targets anaerobic bacteria and may offer superior outcomes in chronic, infected wounds. Objectives To compare the efficacy of Metrogyl dressing versus povidone iodine dressing in the management of diabetic foot ulcers, specifically evaluating wound healing outcomes, infection control, granulation tissue formation, epithelialization rates, number of dressings required, need for split-thickness skin grafts (SSG), and duration of hospital stay. Materials and methods This prospective, randomized, parallel-group comparative study was conducted at Sree Balaji Medical College and Hospital, Chennai, India, from April 2023 to April 2025. A total of 180 adults (aged 40-80 years) with type 2 diabetes and Wagner Grade 2-3 DFUs were randomized into two groups: Group A received 10% metronidazole dressings every 48 hours, while Group B received daily 5% povidone iodine dressings. Both groups received standardized wound care, including sharp debridement, offloading, and glycemic control. Primary outcomes were wound surface area reduction and complete healing at 12 weeks; secondary outcomes included the number of dressings, SSG requirement, and hospital stay. Data were analyzed using SPSS v21.0 (IBM Corp., Armonk, NY, USA), with p<0.05 considered significant. Results Of 180 participants (71.1% male), the Metrogyl group showed a greater reduction in mean wound surface area (from 47.76 ± 24.07 cm² to 36.30 ± 9.56 cm², p<0.001) compared to the povidone iodine group (from 48.32 ± 21.57 cm² to 42.18 ± 18.88 cm², p=0.044). The Metrogyl group required fewer dressings (5.47 ± 0.79 vs. 7.46 ± 1.33, p<0.001), had a smaller SSG area (22.00 ± 3.08 cm² vs. 36.51 ± 12.90 cm², p<0.001), and a shorter hospital stay (32.07 ± 4.79 days vs. 38.68 ± 10.26 days, p<0.001). All differences were statistically significant, indicating superior wound healing and resource utilization with Metrogyl. Conclusion Metrogyl dressing is significantly more effective than povidone iodine in managing diabetic foot ulcers, resulting in faster wound contraction, fewer dressing changes, reduced need for grafting, and shorter hospital stays. Its targeted antimicrobial action and favorable healing profile make it a preferred option for chronic, infected DFUs. Dressing selection, however, should be individualized based on wound characteristics and clinical assessment to optimize patient outcomes.