Efficacy of Magnesium Sulphate (MgSO₄) Dressing versus Normal Saline Dressing in the Management of Cellulitis: A Randomized Controlled Trial MgSO₄ versus Normal Saline Dressing in Cellulitis

Abstract

Background
Cellulitis is a common acute bacterial infection involving the dermis and subcutaneous tissue. Systemic antimicrobial therapy is the cornerstone of treatment, while local measures are frequently used as adjuncts. Magnesium sulfate (MgSO₄) dressings are used in some clinical settings because of their proposed hyperosmolar effect and potential to reduce local tissue edema. However, comparative evidence regarding MgSO₄ dressing versus conventional normal saline dressing in cellulitis is limited.
Aim
To compare the efficacy of magnesium sulfate-soaked dressing with normal saline-soaked dressing as an adjunct to standard antibiotic therapy in patients with uncomplicated cellulitis.
Methods
A prospective, randomized, controlled, parallel-group study was designed at the Department of General Surgery, Saveetha Medical College and Hospital, Thandalam. A total of 200 adult patients with clinically diagnosed uncomplicated limb cellulitis were hypothetically randomized in a 1:1 ratio into two groups. Group A received MgSO₄-soaked dressing (n=100), while Group B received 0.9% normal saline-soaked dressing (n=100), in addition to standard systemic antibiotic therapy. The primary outcome was time to clinical resolution. Secondary outcomes included pain score assessed using the Visual Analogue Scale (VAS), length of hospital stay, antibiotic escalation, progression to abscess or surgical intervention, and dressingrelated adverse events.
Results
The mean age was 49.2 ± 13.1 years in the MgSO₄ group and 48.6 ± 12.8 years in the normal saline group. Baseline demographic and clinical characteristics were comparable between groups. Mean time to clinical resolution was significantly shorter in the MgSO₄ group than in the normal saline group (5.2 ± 1.5 versus 6.4 ± 1.8 days; mean difference −1.2 days; 95% CI −1.64 to −0.76; p<0.001). The day-3 VAS pain score was significantly lower in the MgSO₄ group (3.1 ± 1.2 versus 4.0 ± 1.3; p<0.001). Median hospital stay was also shorter in the MgSO₄ group (5 [IQR 4–6] versus 6 [IQR 5–7] days; p=0.002). Antibiotic escalation occurred in 8% and 16% of patients, respectively (p=0.08). Progression to abscess formation or surgical intervention occurred in 3% versus 7% (p=0.19). Dressing-related adverse events occurred in 7% versus 4% of patients (p=0.35).
Conclusion
In this simulated dataset, MgSO₄ dressing used as an adjunct to standard antibiotic therapy was associated with faster clinical resolution, lower day-3 pain scores, and shorter hospital stay compared with normal saline dressing. These findings are hypothesis-generating and require confirmation using prospectively collected clinical data.