the effect of phenytoin on healing of war and non-war intractable wounds

phenytoin (pht), a drug in clinical use for over fifty years as an anticonvulsant, has heen reported to promote the healing of skin and soft tissue wounds, ulcers and second degree burns. we treated 19 patients with war-related missile wounds and 6 with chronic, non-healing (previously treated at least for.') months with antibiotics and betadine or acetic acid dressing) civilian ulcers with topical phenytoin sodium powder daily without antibiotic therapy for up to 4 weeks. missile wounds had a mean healing time of2 weeks and civilian intractable ulcers, a maximum healing time of4 weeks, compared to historical controls requiring 6-8 weeks for missile wounds and at least 5 months of non-effective previous treatment for intractable wounds. twenty two patients showed complete healing within four weeks. three required skin grafts for final closure. pht provided rapid pain relief. although seventeen wounds had positive bacterial cultures prior to treatment, none were positive after one week of pht treatment. no antibiotics were required. we believe wider use of this safe, inexpensive, readily available, and easy-to-use wound healing agent is indicated.