Efficacy of Propolis in Diabetic Foot Ulcer Management (or Treatment): A Randomized Controlled Trial

Background: The impaired wound healing in diabetes mellitus is a major clinical problem. Propolis has pharmacological characteristics. This study aimed to evaluate the effects of oral, topical, and oral combined with topical administration of propolis on foot ulcers in diabetic patients. Methods: Eighty patients with diabetic foot ulcers were divided into 4 groups. Group 1 received propolis ointment (3%, 1.5 g daily), Group 2 received three 500-mg propolis capsules per day, Group 3 received capsules and ointments, and Group 4 received the usual treatment of foot ulcer, including washing with physiological serum. The patients were treated for 4 weeks. Wound surface area changes were analyzed to determine the effectiveness of the compound in wound healing. Results: The interventions decreased foot ulcer surface areas in all intervention groups (from 685.13 ± 286.16 to 74.89 ± 26.40 mm2 [p = 0.03] in Group 1, from 616.52 ± 221.11 to 104.60 ± 39.81 mm2 [p = 0.046] in Group 2, and from 647.07 ± 23 to 54.20 ± 19.17 mm2 [p = 0.01] in Group 3). In Group 4, however, the reduction in ulcer surface area was not statistically significant. In the three experimental groups, the wounds were clinically improved in all subjects. Conclusion: This study showed that in diabetic foot ulcers, treatment with either oral propolis capsules or combination therapy with oral and topical forms, significantly improves wound healing. Also, the application of these products does not seem to be associated with any unexpected adverse event