Formulation development of hydrocolloid patches for diabetic ulcer therapy with innovative utilization of a combination of Guava leaf and Aloe vera extracts

Diabetic ulcers are a complication in patients with uncontrolled diabetes mellitus (DM), especially on the feet with amputation rates reaching 30%. Wound management with dry gauze can damage new cells because the gauze sticks to the wound and causes pain. The hydrocolloid patch innovation has the advantage of protecting the wound from external factors, providing moisture, and being sterile without causing pain. The combination of guava leaf and aloe vera can help diabetic wounds heal. Guava leaves (Psidium guajava L.) contain saponins, tannins, and flavonoids that effectively inhibit bacterial growth and are antioxidants. While aloe vera contains lignin, saponins, and anthraquinones that can inhibit skin infections, and can maintain skin moisture. The hydrocolloid patch formulation was optimized with Design of Expert 13 using the Box-Behnken method with three responses: swelling test, gel fraction test, and water vapor transmission rate (WVTR) test. The optimum formula was characterized by organoleptic test, pH, water absorption, FTIR, SEM, patch thickness, folding resistance, weight uniformity, drug content uniformity, and drying shrinkage followed by in vivo test and antibacterial test on rat test animals. Based on the results of the study, guava leaf extract and aloe vera can be formulated as a hydrocolloid patch and proven to help heal diabetic ulcers characterized by the percentage of wound closure every day for two weeks. The hydrocolloid patch also proved to be more effective in healing wounds compared to guava leaf extract and aloe vera which were not incorporated into the hydrocolloid patch.