Investigation of the wound healing activity of Carapa guianensis L. (Meliaceae) bark extract in rats using excision, incision, and dead space wound models

The objective of our study is to investigate the wound healing activity of the bark extract of Carapa guianensis in rats using three different wound models. The animals were randomly divided into two groups of six each in all the models. Test group animals were treated topically with the bark extract (200 mg/kg of body weight), and the controls were treated with petroleum jelly in the excision wound model. In the incision and dead space wound models the test group animals were treated with the extract of C. guianensis (200 mg/kg/day) orally by mixing in drinking water, and the control group animals were maintained with plain drinking water. Healing was assessed by the rate of wound contraction, period of epithelialization, skin breaking strength, granulation tissue weight, and hydoxyproline content. Antimicrobial activities of the extract against the microorganisms were also assessed. On day 15 extract-treated animals exhibited 99% reduction in the wound area compared to controls (93%). The extract-treated wounds were found to epithelialize faster than controls (P < .02). The skin breaking strength was significantly higher in extract-treated animals compared to controls (P < .001). The weight and hydroxyproline content of granulation tissue were significantly increased compared to controls. These observations support the use of C. guianensis is in the management of wound healing.

Wound healing potential of ethanolic extract of Kalanchoe pinnata Lam. leaf--a preliminary study

The extract of K. pinnata was evaluated for its wound healing activity by using excision wound model in rats. On day 11, animals treated with the ethanolic leaf extract exhibited 86.33% reduction in the wound area, compared to petroleum jelly treated control (69.36%) and the mupirocin treated standard (85.49%). The hydroxyproline content of extract treated animals was higher, as compared to control and the standard groups. Histological analysis was also consistent with the proposal that K. pinnata leaf extract exhibits significant wound healing potential. The increased rate of wound contraction and hydroxyproline content in the extract treated animals supports the claims made by traditional healers of the benefits obtained from the medicinal use of K. pinnata.

Investigation of wound healing activity of Lantana camara L. in Sprague dawley rats using a burn wound model.

Summary: Lantana camara is used in herbal medicine for the treatment of skin itches, as an antiseptic for wounds, and externally for leprosy and scabies. The objective of our study is to investigate burn wound healing activity of the leaf extract of L.camara in rats. The animals were divided into two groups of 6 each. The test group animals were treated with the ethanol extract of L. camara (100 mg kg-1 day-1) topically and the control group animals were left untreated. Healing was assessed by the rate of wound contraction, period of epithelialization. Antimicrobial activities of the extract against the specific microorganisms were assessed. The extract showed antimicrobial activity against Staphylococcus aureus, Klebsiella Pneumoniae and E.coli. Extract treated wounds were healed in about 21 days which is not distinct from the controls. Our data suggest that L.camara has antimicrobial activity but not wound healing promoting activity on burn wound. Industrial relevance: Extensive work has been done on the L. camara and demonstrated the antimicrobial and fungicidal activity of its chemical constituents. Lantana oil is used for the treatment of skin itches and as an antiseptic for wounds. It has been used in folk medicine for the treatment of cancers, chicken pox, measles, ulcers, swellings, eczema. Our earlier work showed the healing activity on excision wound model. However, there is no data to support the wound healing activity of L. camara on burn wound. Hence, we have conducted the present study to explore the wound healing activity and the antimicrobial activities of L. camara against the specific microorganisms which generally infect burn wound.

Evaluation of the wound-healing activity of ethanolic extract of morinda citrifolia L. Leaf.

Morinda citrifolia L. (noni) is one of the most important traditional Polynesian medicinal plants. The primary indigenous use of this plant appears to be of the leaves, as a topical treatment for wound healing. The ethanol extract of noni leaves (150 mg kg(-1) day(-1)) was used to evaluate the wound-healing activity on rats, using excision and dead space wound models. Animals were randomly divided into two groups of six for each model. Test group animals in each model were treated with the ethanol extract of noni orally by mixing in drinking water and the control group animals were maintained with plain drinking water. Healing was assessed by the rate of wound contraction, time until complete epithelialization, granulation tissue weight and hydoxyproline content. On day 11, the extract-treated animals exhibited 71 per cent reduction in the wound area when compared with controls which exhibited 57 per cent. The granulation tissue weight and hydroxyproline content in the dead space wounds were also increased significantly in noni-treated animals compared with controls (P < 0.002). Enhanced wound contraction, decreased epithelialization time, increased hydroxyproline content and histological characteristics suggest that noni leaf extract may have therapeutic benefits in wound healing.

Effects of Hibiscus rosa sinensis L (Malvaceae) on wound healing activity: a preclinical study in a Sprague Dawley rat.

Hibiscus rosa sinensis (H rosa sinensis), a plant product, has been used for the treatment of a variety of diseases as well as to promote wound healing. The wound-healing activity of the ethanol extract of H rosa sinensis flower was determined in rats, using excision, incision, and dead space wound models and is presented in this report. The animals were randomly divided into 2 groups of 6 each in all the models. Test group animals in each model were treated with the ethanol extract of H rosa sinensis orally by mixing in drinking water (120 mg kg(-1) day(-1)), and the control group animals were maintained with plain drinking water. Healing was assessed by the rate of wound contraction, period of epithelialization, tensile strength (skin breaking strength), granulation tissue weight, and hydroxyproline content. The antimicrobial activity of the flower extract against selected microorganisms that infect the wounds was also assessed. Animals treated with the extract exhibited an 86% reduction in the wound area compared with controls, who exhibited a 75 per cent reduction. The extract-treated animals were found to epithelize their wounds significantly faster than controls (P < .002) and have shown significantly higher skin-breaking strength than controls (P < .002). The dry and wet weight of granulation tissue and hydroxyproline content were also increased significantly when compared with controls. The reported observations suggest H rosa sinensis aids wound healing in the rat model.

Influence of Helium-Neon laser photostimulation on excision wound healing in Wistar rats.

The importance of laser photostimulation is now accepted generally but the laser light facilitates wound healing and tissue repair remains poorly understood. So we have examined the hypothesis that the laser photo stimulation can enhances the collagen production in excision wounds using excision wound model in Wister rat model. The circular wounds were created on the dorsum of the back of the animals. The animals were divided into two groups. The experimental group (n = 12) wound was treated with 632.8 nm He-Ne laser at a dose of 2.1J cmƒ{2 for five days a week until the complete healing. The control group was sham irradiated. The parameters studied were wound area, period of epithelization and hydroxyproline. Significant increase in the hydroxyproline content (p<0.001) and reduction in the wound size (p<0.001) was observed in study group when compared to controls. The significant epithelization (p<0.001) was noticed. The experimental wounds were, on average, fully healed by the 15th day, whereas the control group healed, on average by 22nd day. Wound contraction together with the hydroxyproline and experimental observations suggested that low intensity Helium-Neon laser photo stimulation facilitates the tissue repair process by accelerating collagen production in chronic wounds.

Evaluation of wound healing activity of Allamanda cathartica. L. and Laurus nobilis. L. extracts on rats

BACKGROUND: Allamanda cathartica. L. is a perennial shrub used in traditional medicine for treating malaria and jaundice. Laurus nobilis. L. is a tree and has been used for its astringent, healing and diuretic properties. The objective of this study was to investigate the aqueous extracts of Allamanda and Laurus nobilis to evaluate their wound healing activity in rats.METHODS: Excision and incision wound models were used to evaluate the wound healing activity of both the extracts on Sprague Dawley rats. In each model, animals were divided into four groups of 10 animals each. In both the model, group 1 served as control and group 2 as reference standard. In an excision wound model, group 3 animals were treated with Allamanda (150 mg kg-1 day-1) and group 4 animals were treated with Laurus nobilis (200mg kg-1 b.w day-1) for 14 days respectively. In the case of incision wound model, group 3 and 4 animals were treated with the extracts of Allamanda and Laurus respectively for 10 days. The effects of vehicles on the rate of wound healing were assessed by the rate of wound closure, period of epithelialisation, tensile strength, weights of the granulation tissue, hydroxyproline content and histopathology of the granulation tissue.RESULTS: The aqueous extract of Allamanda promoted wound healing activity significantly in both the wound models studied. High rate of wound contraction (P < .001), decrease in the period of epithelialisation (10.2 ñ0.13), high skin breaking strength (440.0 ñ 4.53), significant increase in the weight of the granulation tissue (P <.001) and hydroxyproline (P < .001) content were observed in animals treated with the aqueous extract of Allamanda. Histological studies of the granulation tissue from the Allamanda treated group showed the presenceof a lesser number of inflammatory cells, and increased collagen formation than the control.

In Laurus nobilis treated animals, the rate of wound contraction, weight of the granulation tissue and hydroxyproline content were moderately high (P < .05). The histological study of the granulation tissue of the Laurus nobilis treated animals showed larger number of inflammatory cells, and lesser collagen when compared with the Allamanda treated group of animals. However, it was better than the control group of animals.CONCLUSION: The data of this study indicated that the leaf extract of Allamanda possesses better wound healing activity than the Laurus nobilis and it can be used to treat different types of wounds in human beings too.

Cecropia peltata L(Cecropiaceae) has wound-healing potential: a preclinical study in a Sprague Dawley rat model.

The plant Cecropia peltata is used in traditional medicine to treat a variety of disorders. The objective of the study presented in this report was to screen the extracts of this plant leaf for its wound-healing properties based on its traditional use for wound healing. Aqueous and ethanol extracts were prepared for topical and oral administration. The dose studied was 150 mgkg(-1)day(-1) for 10 days, using the excision wound model in rats. Carboxymethyl cellulose (1 per cent) was used as control in topical and oral route studies. Animals were randomized to treatment or control, the experiment being done with prior ethical approval from the university. Wound areas were measured. On day 11, tissue was excised to determine the contents of protein, hydroxyproline, and hexosamine. Wound areas reduced statistically significantly in all treatment groups compared to respective controls (P < .001). Biochemistry and tissue histology outcomes were consistent with changes in the treatment groups. No differences were detected within the treatment groups. The study permits the conclusion that Crecopia peltata has wound-healing potential.

Cecropia peltata L(Cecropiaceae) has wound-healing potential: a preclinical study in a Sprague Dawley rat model

The plant Cecropia peltata is used in traditional medicine to treat a variety of disorders. The objective of the study presented in this report was to screen the extracts of this plant leaf for its wound-healing properties based on its traditional use for wound healing. Aqueous and ethanol extracts were prepared for topical and oral administration. The dose studied was 150 mgkg-1day-1 for 10 days, using the excision wound model in rats. Carboxymethyl cellulose (1 per cent) was used as control in topical and oral route studies. Animals were randomized to treatment or control, the experiment being done with prior ethical approval from the university. Wound areas were measured. On day 11, tissue was excised to determine the contents of protein, hydroxyproline, and hexosamine. Wound areas reduced statistically significantly in all treatment groups compared to respective controls (P < .001). Biochemistry and tissue histology outcomes were consistent with changes in the treatment groups. No differences were detected within the treatment groups. The study permits the conclusion that Crecopia peltata has wound-healing potential.

Evaluation of wound healing activity of Vanda roxburghii R.Br(Orchidacea): a preclinical study in a rat model.

The extract of Vanda roxburghii was administered topically to rats at a dose of 150mgkg(-1) day(- 1) for 10 days and was studied for its effect on wound healing, using the excision wound model. A 60 per cent reduction in wound diameter was observed in the test group rats receiving the extract compared to controls (48 per cent). Significant increases in wet and dry granulation tissue weights (P < .001), hydroxyproline (P < .001), and hexosamine (P < .003) contents were detected. An increase in protein content was also detected in the test group (P > .05, ns). These findings are consistent with wound healing at cellular levels. The pro-healing action may be attributed either to increased collagen deposition or to better alignment and maturation or both. The test wounds (extract-treated wounds) were, on average, fully healed by the 13th day, whereas the control group healed, on average, by the 20th day. These data suggest that the extract of Vanda roxburghii administered topically has wound-healing potential in rats.

Experimental evaluation of Pentas lanceolata flowers for wound healing activity in rats.

The ethanolic extract of the flowers of Pentas lanceolata given by oral route to rats at dose of 150 mg kg(-1) day(-1) for 10 days, was studied for its effect on wound healing, using excision wound mode. Significant increase in granulation tissue weight, tensile strength, hydroxyproline and glycosaminoglycan content was observed. Moderate increase in protein content was seen. There was significant reduction in the wound area measurement of the test group as compared to that of controls. The efficacious prohealing action may be due to increased collagen deposition as well as better alignment and maturation.

The biomechanical management of diabetic foot ulcers

The primary goal in the treatment of diabetic foot ulcers is to obtain wound closure as expeditiously as possible and prevent the recurrence of a foot wounds due to neuropathy, foot deformity, and poor circulation. Intervention that bring about the quick resolution of a foot wound and reduce the rate of recurrence have been shown to lower the risk of developing a secondary infection and decrease the incidence of lower extremity amputation in the diabetic patient.(Au)

The influence of persistent hyperglycaemia of hyperfibrinogenaemia and hyperviscosity in diabetes mellitus

The effect of hyperglycaemia on hyperfibrinogenaemia and its consequence on plasma viscosity was investigated in 69 diabetic patients during the course of hypoglycaemic treatment. Glycaemic control was assessed by measurement of glycosylated haemoglobin (HbA). Plasma fibrinogen concentration (PFC) was determined by a clot-weight method. The relative plasma viscosity (RPV) was measured by capillary viscometry. The mean PFC and RPV were significantly (p<0.001) elevated in the diabetic patients as compared with a non-diabetic control group. Both PFC and RPV showed a distinct, step-wise increase with progressively poorer glycaemic control. The data strongly indicate that persistent hyperglycaemia is associated with a frank hyperfibrinogenaemia and hyperviscous plasma in most of the diabetic patients studied. These abnormal haemorrheological changes could impact adversely on both the haemostatic process and circulation in diabetic patients(Au)

A comparison of the use of plain catgut, skin tapes and polyglactin sutures for skin closure: a propsective clinical trial

A prospective clinical trial was carried out to compare the effect, on wound healing, of the use of polyglactin, plain catgut sutures, or skin tapes, in the closure of 190 groin crease incisions in children. The final outcome variable analysed was uneventful healing, defined as the absence of wound erythema, four successive observation periods, up to 11 months post-operatively. Wounds closed with polyglactin (P=<0.5). This association diminished over subsequent observation periods. Skin tapes were cheapest of the skin edges. Patient age (P=<0.01 to <0.05) and sex (P<0.01) also exercised an effect on wound outcome, particularly at the final observation point. The reason for this was not determined. The results of this trial favour the use of polyglactin sutures over plain catgut and skin tapes in the closure of groin crease incisions in the population studied (AU)

Sutureless closure of traumatic wounds - abstract

Traumatic wounds are one of the commonest problems presenting to Accident and Emergency Departments. The most popular method of skin closure is suturing. However, this requires suture material, sterile equipment, operating room, cleaning solution, local anaesthesia and an assistant. In the Third World Accident and Emergency Departments setting these may not be readily available. Because of our chance observation that tape closure without cleaning and anaesthesia produced good healing in traumatic wounds we subjected the technique to a prospective analysis in consenting patients. A total of 147 lacerations, 8 cm long (range 2-17 cm) were closed with adhesive tape without cleaning the wounds. Wounds with obvious gross contamination and particulate matter were excluded. On follow up visits at 5 and 10 days, the sepsis rate was 1.36 percent and overall complication rate 2.7 percent. Patient satisfaction was excellent as they had a very short wait for treatment, no injections or suturing and no need for suture removal. Tape closure is associated with less wound sepsis than suturing. As we found, the results compare favourably with suturing. Because it is cheaper, quicker, requires no instruments or special facilities we recommend it for the treatment of traumatic wounds. (AU)

Postural vasoconstriction and leg ulceration in homozygous sickle cell disease

Chronic leg ulceration is a major cause of morbidity in patients with homozygous sickle cell disease; the ulcers commonly resolve on bed rest. We have therefore compared the cutaneous vascular response to dependency in three groups of eight patients with sickle cell disease (those with an active ulcer, with an ulcer scar and with no history of ulceration) and in eight subjects with normal haemoglobin and no history of leg ulceration. We monitored with a laser Doppler flowmeter, the change in red cell (erythocyte) flux induced in the skin of the leg, at two sites proximal to the malleoli, with the leg horizontal and 5 and 10 min after moving the leg to the dependent position. With the leg horizontal, mean cutaneous red cell flux was was substantially higher in normal cells of patients with sickle cell disease than in normal subjects and was higher still at the site of the ulcer scar. On dependency, red cell flux fell not only in normal subjects but also in the patients with the sickle cell disease. The fall in red cell flux in normal skin of patients with sickle cell disease was smaller than in normal subjects when considered as a percentage of the control values, but in absolute terms the falls in red cell were similar in sickle cell patients normal subjects. By contrast, the fall in red cell flux at the ulcer/scar site was greater than in normal skin from sickle cell patients. We propose that high resting perfusion is important in patients with sickle cell disease to maintain normal integrity of cutaneous tissue and that pronounced vasoconstriction on dependency hinders the healing and encourages recurrence of the leg ulcers (AU)

Wound healing in the Accident and Emergency Unit at the University Hospital of the West Indies, Jamaica - abstract

During a three-month period, data on all wounds sutured primarily in the Accident and Emergency Unit at the University Hospital of the West Indies were collected. This study was made to determine healing rates of these wounds treated in segregated area in the Unit without the use of aseptic conditions. During the study period, 205 patient were sutured, of whom 179 cases with 189 wounds returned for review. Lacerations formed the largest group (164 wounds). The healing rate for all wounds was 93.6 percent. Twelve wounds failed to heal satisfactorily. Five of the eleven contusions in the study fell into this group. It was concluded that operating theatre conditions were not necessary for good healing and that contusions might be better treated by delayed primary suture(AU)

Clinical and cost effectiveness of prophylactic parenteral penicillin in the care of simple wounds undergoing suture repair

Physicians working in casualty and outpatient departments where adverse conditions prevail often prescribe antibiotic prophylaxis routinely at the time of suture repair of simple wounds. To evaluate this practice, we performed a randomized, controlled study of parenteral chemoprophylaxis of simple wounds undergoing suture repair. Uncomplicated wounds were randomized to either treatment with a combination of benzathine penicillin (2.4 million units) and procaine penicillin (2.0 million units) intramuscularly, or a control group. At the time of suture removal, seven days later, all wounds were reviewed for signs of infection. Of 320 patients enrolled in the study, 173 (54.1 percent) returned for review. Among treated wounds, 75 of 81 (92.6 percent) were healing, compared to 79 of 92 (85.9 percent) controls (p=0.24). A significantly higher rate of healing was observed when wounds repaired nine or more hours after injury and involving the arms, legs, or trunk were treated (22 of 23, 95.7 percent) compared to those in whom prophylaxis was omitted (20 of 30, 66.7 percent) (p=0.03). Wounds involving the head, and wounds repaired within nine hours after injury had a high rate of healing (>90 percent), whether prophylaxed or not. Based on a 30 percent higher healing rate for the patients who benefitted from treatment (arm, leg, trunk wounds repaired after nine or more hours), the drug cost of implementing prophylaxis for this group alone was more than five times that of an expectant, non-prophylactic strategy. These results serve to remind practitioners of the possibility that a clinically effective mode of therapy may not necessarily be cost-effective in the delivery of health care.(AU)