Background: Diabetic foot ulcers (DFUs) are one of the most devastating consequences of diabetes mellitus, frequently resulting in infection, amputation, and extended morbidity. Traditional dressings generally aim to provide a moist environment and avert infection, although frequently do not expedite healing in chronic wounds. Topical insulin has evolved as an innovative, economical treatment alternative owing to its anabolic, angiogenic, and anti-inflammatory characteristics that facilitate cellular proliferation and tissue healing.

Aims: The study aims to compare the efficacy of topical insulin dressings versus conventional dressings in the management of non-healing diabetic ulcers.

Materials and Methods: This prospective comparative study was conducted over a period of 10 months at the Department of General Surgery, including 70 patients with non-healing diabetic ulcers fulfilling inclusion criteria. Patients were randomly divided into two groups of 35 each. Group A received topical regular insulin dressing, prepared by diluting 1 mL (10 IU) of insulin in 1 mL of normal saline and applied once daily under aseptic precautions. Group B received conventional normal saline dressings following standard wound care protocols. All patients underwent strict glycemic control and appropriate antibiotic therapy based on culture sensitivity. Ulcer size, depth, granulation tissue formation, and epithelialization were measured weekly for 8 weeks using standardized wound assessment charts. Healing rates were compared statistically using the Student’s t-test and Chi-square test, with p < 0.05 considered significant.

Results: The mean decrease in ulcer area after 8 weeks was significantly higher in the topical insulin group (72.8 ± 10.4%) than in the conventional dressing group (48.6 ± 12.2%) (p < 0.001). The average time for the emergence of healthy granulation tissue was 10.2 ± 2.1 days in Group A compared to 16.5 ± 3.2 days in Group B. Complete epithelialization was observed in 65.7% of patients in Group A and 34.2% in Group B during the research period. The infection rate and duration of hospitalization were significantly reduced in patients administered topical insulin.

Conclusion: Topical insulin is a safe, inexpensive, and effective adjunct in the management of non-healing diabetic ulcers. It significantly enhances granulation tissue formation, accelerates epithelialization, and reduces overall healing time compared to conventional dressings. Incorporating topical insulin into standard wound care protocols can improve outcomes, particularly in resource-limited settings where cost-effective interventions are essential.

KEYWORDS: Topical Insulin, Diabetic Foot Ulcer, Wound Healing, Conventional Dressing, Granulation Tissue, Epithelialization, Glycemic Control.