Comparison of the effects of cilostazol and aspirin on wound healing in patients with diabetic foot ulcer and peripheral artery disease

Abstract

Diabetic foot ulcer (DFU) is one of the most feared complications of diabetes mellitus. Studies report that the lifetimerate of developing DFU is 25% for patients with diabetes mellitus. In addition, peripheral artery disease (PAD) is seen in approximately 50% of patients with DFU. PAD increases the risk of amputation in patients with DFU and complicates treatment.

This study aimed to compare the effects of cilostazol and aspirin on wound healing in patients with DFU and PAD. In the study, DFU patients with PAD were retrospectively reviewed. They were divided into two groups. One group was administeredcilostazoland the other was administeredaspirin. Patients were evaluated according to their demographic characteristics, wound characteristics, PAD symptoms, duration of treatment, and treatment grades.

There were 30 patients in the cilostazol group and 20 patients in the aspirin group. Of the patients in the cilostazol group, seven(23.3%) had Wagner’s grade 2, 16 (53.3%) had grade 3, and seven (23.3%) had grade 4 DFU. In the aspirin group this rate was 25%, 55%, and 20%, respectively. The mean size of the wound in the cilostazol group was 8.1 cm (2-25 cm), whereas it was 7.6 cm (5-25 cm) in the aspirin group. The mean ankle-brachial index (ABI) of the patients was 0.90 in the cilostazol group and 0.96 in the aspirin group. Five (23.3%) of the patients in the cilostazol group had triphasic, 19 (63.3%) biphasic, and six(20%) monophasic currents in the distal popliteal vein. In the aspirin group, these rates were 35%, 50%, and 20%, respectively. Of the patients in the cilostazol group, according to the Fontaine classification, six(20%) had stage 2A, 11 (36.7%) had stage 2B, 10 (33.3%) had stage 3, and three(10%) had stage 4 symptoms. In the aspirin group, these rates were 45%, 40%, 15%, and 0%, respectively. There was a complete response to treatment in 27 patients (90%) in the cilostazol group and 11 patients (55%) in the aspirin group. Partial response was present in the other patients. The mean duration of treatment was 1.31 months (1-2 months) in the cilostazol group and 1.82 months (1-2.5 months) in the aspirin group.

In this study, it was observed that wound healing was faster in the cilostazol group, complete response to treatment was higher, and improvement in PAD symptoms was better compared to the aspirin group.