"Ultrasound-Enhanced Propolis Therapy for Healing Diabetic Foot Wounds"

This randomized, double-blind, controlled clinical trial investigates the therapeutic effectiveness of propolis phonophoresis in treating diabetic foot ulcers (DFUs). DFUs affect approximately 25% of diabetic patients and are associated with high morbidity, prolonged healing, and significant healthcare costs. Propolis, a resinous substance produced by honeybees, has shown antimicrobial, anti-inflammatory, and wound-healing properties in previous studies. However, its limited skin permeability reduces its clinical utility when used topically.

Phonophoresis is a non-invasive technique that uses ultrasound waves to enhance transdermal drug delivery. This study combines a 10% propolis gel with therapeutic ultrasound (1 MHz, 0.5-1.5 W/cm², pulsed mode at 20%) to evaluate its impact on wound healing outcomes compared to standard wound care. The intervention group will receive propolis phonophoresis therapy three times per week for four weeks. The control group will receive standard wound care and a sham ultrasound.

Primary outcome measures include the percentage reduction in wound area, assessed via digital planimetry. Secondary outcomes include time to full wound closure, pain scores, infection rates, and quality-of-life assessments. The study is designed to explore whether this combined therapeutic approach can offer a clinically superior and non-surgical treatment alternative for patients with chronic diabetic ulcers.

Inclusion criteria

Adults aged 18 to 75 years

Diagnosed with type 1 or type 2 diabetes mellitus

Presence of a diabetic foot ulcer classified as Grade 1 or 2 (Wagner classification)

Ulcer size between 1 cm² and 5 cm²

Able and willing to provide informed consent

Exclusion criteria

Severe infection or presence of osteomyelitis at the ulcer site

Use of systemic immunosuppressants or corticosteroids

Known allergy or hypersensitivity to propolis

Pregnant or breastfeeding women

Participation in another clinical trial within the past 30 days