TOPLINE:

A randomized study found that topical probiotics in soybean concentrate significantly improved complete healing rates and shortened healing time in diabetic foot ulcers (DFUs) compared with placebo over 24 weeks.

METHODOLOGY:

• Researchers conducted multicenter, prospective, double-blind, randomized controlled trial of 58 patients (mean age, 62 years) with 58 nonhealing, noninfected DFUs at three hospitals in Taiwan between January 2022 and June 2024.
• Participants were randomly assigned in blocks of eight to receive either a probiotic formulation containing Bifidobacterium bifidum, Lactobacillus acidophilus, and Lactobacillus casei in an 8% soybean-based concentrate (n = 32) or placebo (n = 22), applied twice daily in addition to standard wet-to-dry dressings.
• The primary outcome was complete wound healing within 24 weeks, defined as full re-epithelialization without drainage or dressing requirement on two consecutive visits.
• Secondary outcomes included percentage reduction in ulcer area, time to healing, recurrence, infections, amputations, mortality, and adverse events.

TAKEAWAY:

• Complete healing of DFUs occurred significantly more often in the probiotic group vs placebo group at 24 weeks (94.4% vs 63.6%; P = .003).
• Mean time to healing was significantly shorter with probiotics than with placebo (89.6 vs 165.9 days; P = .012).
• Kaplan-Meier analysis demonstrated faster healing with probiotics (hazard ratio, 2.83; P = .012).
• Healing rates were consistently achieved earlier in the probiotic group, with 25%, 50%, 75%, and 100% wound reduction at 22.4, 29.4, 49.0, and 89.6 days vs 30.8, 49.7, 84.0, and 165.9 days, respectively in the placebo group.

IN PRACTICE:

“This trial showed that topical probiotics significantly accelerates healing of DFUs compared with placebo,” the authors wrote. “This approach is low-cost, easy to apply, and well tolerated in home-care settings,” they added.

SOURCE:

The study was led by Honda Hsu, MBChB, and Shih-Ming Huang, School of Medicine, Tzu Chi University, Hualien, Taiwan, and Chao-Chih Yang, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, and was published online on March 27 in a letter to the editor in the British Journal of Dermatology.

LIMITATIONS:

Limitations included modest sample size, lack of blinded photographic adjudication, and follow-up restricted to 24 weeks.

DISCLOSURES:

This study did not receive any specific funding, and the authors disclosed having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.