Moxibustion Promotes Formation of Granulation in Wound Healing Process through Induction of Transforming Growth Factor-ß in Rats.

OBJECTIVE: To examine the effect of moxibustion on the wound healing process and its mechanism using a rat wound model. METHODS: Sixty male Sprague-Dawley rats were randomly divided into a sham-treated group (n=30, wound surgery only) and a moxibustion group (n=30, wound treated with moxibustion). Circular full-thickness skin wounds were produced in rats. Moxibustion was applied to the edge of wound and was continued on alternating days till 14 days after surgery, followed by measurement of wound size. Expression of collagens, prolyl-4-hydroxylase (P4H) and transforming growth factor-ß (TGF-ß) were evaluated by histochemical study and real-time polymerase chain reaction. RESULTS: The size of the wound lesion was significantly reduced in rats treated with moxibustion as compared to that in sham-treated rats at 4-10 days after wounding (P<0.01). Moxibustion stimulated mRNA expression of collagens at 4 days (P<0.01), but not at 7 days, accompanied by enhanced proliferation of P4H-positive fibroblasts. Of importance, expression of TGF-ß in tissue from the wound lesion treated with moxibustion was significantly increased as compared to that in sham-treated rats at 4 days (P<0.01 or P<0.05), but not at 7 days. CONCLUSIONS: The treatment with moxibustion promoted the wound healing process in the early phase through proliferation of fibroblasts and rapid formation of granulation, possibly mediated by induction of TGF-ß which is a key molecule in the physiological process of wound healing. Moxibustion can be expected to be effective as complementary treatment for intractable ulcers.

An Alternative Treatment Strategy for Complicated Chronic Wounds: Negative Pressure Therapy over Mesh Skin Graft.

Extensive skin defect represents a real problem and major challenge in plastic and reconstructive surgery. On one hand, skin grafts offer a practical method to deal with skin defects despite their unsuitability for several complicated wounds. On the other hand, negative pressure wound therapy (NPWT), applied before skin grafting, promotes granulation tissue growth. The aim of the study is to evaluate the improvement in wound healing given by the merger of these two different approaches. We treated 23 patients for large wounds of multiple factors. Of these, 15 were treated with the application of V.A.C.® Therapy (KCI Medical S.r.l., Milan, Italy), in combination with skin grafts after a prior unsuccessful treatment of 4 weeks with mesh skin grafts and dressings. Another 8 were treated with only mesh skin graft. Pain reduction and wound area reduction were found statistically significant (p < 0.0009, p < 0.0001). Infection was resolved in almost all patients. According to our study, the use of the negative pressure wound therapy over mesh skin grafts is significantly effective especially in wounds resistant to conventional therapies, thereby improving the rate of skin graft take.

[Effects of Xiaodu Yuji Paste on Protein Expressions of VEGF/SDF-1 a/CXCR4 in Granulation Tissue of Diabetic Foot Patients].

Objective To observe the effects of Xiaodu Yuji Paste (XYP) on protein expressions of vascular endothelial growth factor (VEGF)/stromal cell derived factor la (SDF-1a)/chemokine recep- tor 4 (CXCR4) in granulation tissue of diabetic foot patients. Methods Totally 56 patients with diabetic foot were assigned to the control group (29 cases) and the treatment group (27 cases) according to Wagner grading method (the range and the degree of foot lesion). Patients in the control group received basic treatment (anti-inflammation, blood glucose control, anti-coagulation, debridement, drainage, and so on) for 8 weeks. Patients in the treatment group additionally received XYP for 8 weeks. The wound healing was observed. Contents and protein expressions of VEGF/SDF-1 a/CXCR4 were detected using SP method and Western blot. Results The wound healing rates after 2, 4, 8 weeks of treatment were signifi- cantly higher in the treatment group than in the control group (all P <0. 05). Contents and protein expres- sions of VEGF/SDF-1 a/CXCR4 protein expression at week 8 after treatment were all significantly higher in the treatment group than in the control group (P <0. 05). Conclusion The therapeutic effect of XYP might be associated with promoting expressions of VEGF/SDF-la/CXCR4, thus promoting angiogenesis and facilitating wound healing.

Appraisal on the wound healing activity of different extracts obtained from Aegle marmelos and Mucuna pruriens by in vivo experimental models.

AIM: The use of a simple and reproducible model is inevitable for an objective statement of the effects of external factors on wound healing. Hence, the present study was conducted to evaluate wound healing activities of sequential different extracts of Aegle marmelos leaves (AM) and Mucuna pruriens seeds (MP) by in vivo experimental models. MATERIALS AND METHODS: Wistar albino rats were subjected to excision, incision and dead space wounds measuring approximately 250 mm2, 3 cm and implanting sterilized polyvinyl chloride tube on the back of each rat near either side of the vertebral column respectively. The experimental animals were randomized into eight groups (n = 6), control, standard and treatment groups. Hydrogel of different extracts were applied topically once daily. The parameters observed were percentage of wound contraction, epithelization period, tensile strength, hydroxyproline content of the granulation tissue, and histological changes during wound healing. RESULTS: The statistical study revealed that in excision, incision, and dead space wound models all formulations have significant (P < 0.01) wound healing potential. However, methanolic extract formulation was found to be superior to all other treatments as evidenced by rapid wound contraction, lesser number of days required for complete epithelization, increased tensile strength and significant increase in hydroxyproline content. CONCLUSIONS: As compared to the reference standard treated group the wound healing process of the experimental groups was decelerated. All extracts obtained from AM and MP facilitated the wound healing process in all experimental models.

Struthanthus vulgaris ointment prevents an over expression of inflammatory response and accelerates the cutaneous wound healing.

ETHNOPHARMACOLOGICAL RELEVANCE: Struthanthus vulgaris (Vell.) Mart. (Loranthaceae) has been largely used in traditional folk medicine in Brazil as an anti-inflammatory agent and to treat various skin disorders, including wounds. AIMS OF THE STUDY: To investigated the influence of 5% Struthanthus vulgaris ointment during cutaneous wound healing in rats. MATERIALS AND METHODS: Twenty Wistar rats were used in each group according the daily treatment, S. vulgaris 5% ointment (SV 5%) and vehicle control groups. Four full thicknesses wounds were punched in back side skin of each animal, and five animals were sacrificed after 2, 7, 14 and 21 days after surgery for histological, immunological and biochemical analysis. RESULTS: A significant wound closured area in the S. vulgaris 5% group of about 38% and 35% as compared to 19% and 21% in the control group was observed after 2 and 5 days, respectively. Histological and biochemical analysis of the skin biopsies showed that S. vulgaris treated wounds exhibited increased granulation tissue and regulated the inflammatory response by modulating the release of pro and anti-inflammatory cytokines like IL-1α, TNF-α and IL-10, nitric oxide and, growth factors like TGF-ß. Moreover, S. vulgaris showed a marked and robust increase in the deposition and organization of collagen fibers in the wounds, and improve the quality of the scar tissue. CONCLUSIONS: Altogether these data revealed that S. vulgaris seems to prevent an over expression of inflammation and accelerates wound epithelialization and might be beneficial for treating healing disorders.

The effect of topical ethanol extract of Cotinus coggygria Scop. on cutaneous wound healing in rats.

The aim of this study is to determine the cutaneous wound healing effects of the ethanol extract of Cotinus coggygria leaves in rats by excision wound model to provide scientific evidence for the traditional use of C. coggygria Scop. The levels of malondialdehyde, catalase, superoxide dismutase, glutathione and hydroxyproline were investigated in wound tissues. Histopathological examination was also performed. The hydroxyproline content of the granulation tissue and the glutathione levels were both significantly higher in the treatment group than in the control group (p < 0.05 for both); while the malondialdehyde levels were significantly lower in the treatment group (p < 0.05). These results were supported with histological results. The ethanol extract of C. coggygria Scop could be considered as an effective agent in wound healing in accordance with its traditional use.

Xanthine Oxidoreductase Function Contributes to Normal Wound Healing.

Chronic, nonhealing wounds result in patient morbidity and disability. Reactive oxygen species (ROS) and nitric oxide (NO) are both required for normal wound repair, and derangements of these result in impaired healing. Xanthine oxidoreductase (XOR) has the unique capacity to produce both ROS and NO. We hypothesize that XOR contributes to normal wound healing. Cutaneous wounds were created in C57Bl6 mice. XOR was inhibited with dietary tungsten or allopurinol. Topical hydrogen peroxide (H2O2, 0.15%) or allopurinol (30 µg) was applied to wounds every other day. Wounds were monitored until closure or collected at d 5 to assess XOR expression and activity, cell proliferation and histology. The effects of XOR, nitrite, H2O2 and allopurinol on keratinocyte cell (KC) and endothelial cell (EC) behavior were assessed. We identified XOR expression and activity in the skin and wound edges as well as granulation tissue. Cultured human KCs also expressed XOR. Tungsten significantly inhibited XOR activity and impaired healing with reduced ROS production with reduced angiogenesis and KC proliferation. The expression and activity of other tungsten-sensitive enzymes were minimal in the wound tissues. Oral allopurinol did not reduce XOR activity or alter wound healing but topical allopurinol significantly reduced XOR activity and delayed healing. Topical H2O2 restored wound healing in tungsten-fed mice. In vitro, nitrite and H2O2 both stimulated KC and EC proliferation and EC migration. These studies demonstrate for the first time that XOR is abundant in wounds and participates in normal wound healing through effects on ROS production.

Low-level red laser improves healing of second-degree burn when applied during proliferative phase.

The aim of this study was to investigate the effects of low-level red laser on tissue repair in rats submitted to second-degree burn, evaluating if the timing of laser treatment influences the healing process. The animals had their backs shaved and divided as follows: control group (n = 12)-rats burned and not irradiated, early laser group (n = 12)-rats burned and irradiated from day 1 after injury for five consecutive days, and late laser group (n = 14)-rats burned and irradiated from day 4 after injury for five consecutive days. Laser irradiation was according to a clinical protocol (20 J/cm(2), 100 mW, continuous wave emission mode, 660 nm) as recommended by the laser device manufacturer. Half of the animals were sacrificed 10 days after burn, and the other animals were sacrificed 21 days after burn. The late laser group accelerated wound contraction 10 and 21 days after burn. The late laser group accelerated reepithelialization 18 days after burn. The late laser group increases the granulation tissue 10 and 21 days after burn. Both irradiated groups increased type III collagen expression and TGF-ß 21 days after burn. Both irradiated groups increased macrophage and myofibroblast numbers 10 days after burn and decreased 21 days after. Low-level red laser exposure contributes to the process of tissue repair of second-degree burns, but the intervention during proliferative phase is crucial in the final outcome of the repair process.

[Dynamics of local expression of connexin-43 and basic fibroblast growth factor receptors in patients with skin and soft-tissue infections against the background of diabetes mellitus type II].

Clinical results of wound healing dynamics were studied in 60 patients with soft-tissue infection against the background of diabetes mellitus type II. At the same time the study considered indices of intercellular contacts protein tissue expression such as connexin 43 (Cx43) and basic fibroblast growth factor receptors (bFGFR). The basic therapy of biopsy material of wound borders was applied. The reduction of bFGFR expression and the minor growth of Cx43 expression were observed. The pain syndrome proceeded for a long time and there were signs of perifocal inflammation, retard wound healing with granulation tissue. The application of combined method of ozone therapy which included autohemotherapy with ozone and an external management of wound by ozone-oxygen mixture facilitated to considerable shortening of inflammatory phase and regeneration. It was associated with increased Cx43 expression (in 1.9 times) in comparison with initial level and bFGFR was enlarged in 1.7 times to eighth day of postoperative period.

Wound healing efficacy of Jatyadi Taila: in vivo evaluation in rat using excision wound model.

ETHNOPHARMACOLOGICAL RELEVANCE: In traditional Indian medicinal treatise there are several Ayurvedic formulations mentioned which have been claimed as potential wound healing agents like Madhu Ghrita and Jatyadi Taila. Jatyadi Taila (JT) is a medicated oil formulation (Taila) popularly used in the treatment of various topical wounds. AIM OF THE STUDY: Though JT has its composition recorded in ancient Ayurvedic texts, there have been minimal attempts to standardize its use in the management of wound. The current work evaluates the wound healing efficacy of JT and also provides evidence of the dermal absorption kinetics of Karanjin from JT. MATERIALS AND METHODS: JT was subjected to preliminary phytochemical evaluation. Therapeutically active marker components ß-sitosterol, lupeol and karanjin were detected and separated using HPTLC. As a part of safety evaluation, skin irritation potential of JT was evaluated on rabbit skin. Excision wound model in rats were used to evaluate the wound healing efficacy of JT. Histopathological and biochemical evaluations of excised skin tissues at wound sites were carried out. The HPTLC method developed was also validated to evaluate the pharmacokinetics of Karanjin from JT after topical application on pinna of rabbit. RESULTS: Preliminary phytochemical evaluation of JT revealed presence of flavonoids, essential oils, tannins, glycosides, steroids and alkaloids while resins were found to be absent. HPTLC confirmed the presence of karanjin, lupeol and ß-sitosterol in JT. JT was found to be non-irritant when applied to the skin of rabbits. Topical application of JT on excision wounds caused significantly faster reduction in wound area as compared to the application of modern topical formulation (Neosporin(®)) and untreated control wounds. Animals treated with JT showed significant increase in protein, hydroxyproline and hexosamine content in the granulation tissue when compared with the untreated controls. Wound healing potential of JT was found to be dose dependant. HPTLC method was successfully used to evaluate the pharmacokinetics of Karanjin after topical application of JT on rabbit pinna. CONCLUSIONS: Current work demonstrates a modern approach towards standardization of the use of traditional topical formulation JT. The results justify the traditional claim of JT for its use in the management of wounds.

Effect of LED phototherapy (λ700 ± 20 nm) on TGF-ß expression during wound healing: an immunohistochemical study in a rodent model.

OBJECTIVE: The aim of the present investigation was to evaluate transforming growth factor ß (TGF-ß) expression on cutaneous wounds in rodents treated or not treated with LED light. BACKGROUND: TGF-ß is a multifunctional cytokine that presents a central action during tissue repair. Although several studies both in vitro and in vivo have shown that LED phototherapy influences tissue repair, a full understanding of the mechanisms involved in its usage, such as in the modulation of some growth factors, remains unclear. MATERIALS AND METHODS: Under general anesthesia, 24 young adult male Wistar rats weighing 200-250 g had one excisional wound created on the dorsum of each, and were randomly distributed into two groups: G0 (Control) and G1 (LED, λ700 ± 20 nm, 16 mW, SAEF = 5 J/cm(2), Illuminated Area = 2 cm(2), 8 mWcm(2), 626 s) Each group was subdivided into three subgroups according to the animal death timing (2, 4, and 6 days). LED phototherapy started immediately after surgery and was repeated every other day during the experimental time. Following animal death, specimens were removed, routinely processed to wax, cut and immunomarked with polyclonal anti-TGF-ß, and underwent histological analysis by light microscopy. The mean area of expression of each group was calculated. The data were statistically analyzed using ANOVA and Tukey's test. RESULTS: The area of the expression of TGF-ß on LED-irradiated animals was significantly smaller than on controls at day 2 (p = 0.013). No significant difference was found at later times. It is concluded that the use of LED light, at these specific parameters, caused an inhibition of the expression of TGF-ß at an early stage of the healing process.

Effect of dehydrozingerone, a half analog of curcumin on dexamethasone-delayed wound healing in albino rats.

Oxidative stress is triggered by the wound which results in the production of reactive oxygen species (ROS), thereby delaying normal wound repair. Therefore, it is important to reduce the level of ROS to improve healing. A known antioxidant, dehydrozingerone (DHZ) was synthesized and selected for the study. The authors aimed to investigate the wound healing action of topical (100 mg/wound) and systemic (100 mg/kg, p. o.). DHZ on different wound models in normal and dexamethasone (DEX)-suppressed healing. Topical DHZ showed a significant (P < 0.05) rise in tensile strength when compared to control in normal healing. Significant (P < 0.05) wound closure was observed from 3 to 9 days in DHZ oral and gel treated groups. There was a significant (P < 0.05) rise in hydroxyproline content with the DHZ treated groups when compared to control. Systemic DHZ exhibited a significant (P < 0.05) increase in lysyl oxidase (LO) levels of 3.73 ± 0.15 nmol of H(2)O(2) when compared to control. In DEX-suppressed healing, showed good pro-healing activity with respect to the parameters mentioned above. DHZ treatment exhibited a parabolic dose response of ROS inhibition with a plateau effect at 75 µM. There was a steady and constant increase in the % NO inhibition with increasing doses of DHZ. Oral DHZ is effective in accelerating the healing process in both normal and dexamethasone-suppressed wounds. Our study suggests that DHZ (half analog of curcumin) supplementation reduces the steroid-induced delay in wound healing.

Effect of topical application of virgin coconut oil on skin components and antioxidant status during dermal wound healing in young rats.

OBJECTIVES: The present study was undertaken to evaluate the effect of a topical application of virgin coconut oil (VCO) on excision wounds in young rats. METHODS: Three sets of experiments with 3 groups of female Sprague-Dawley rats each consisting of 6 animals were used for studying wound closure time, antioxidant status and biochemical parameters. Group 1 was the control; groups 2 and 3 were treated with 0.5 and 1.0 ml VCO, respectively, 24 h after wound creation for 10 days. After the experimental period, the healing property of VCO was evaluated by monitoring the time taken for complete epithelization as well as levels of various parameters of the wound's granulation tissue. The collagen solubility pattern, glycohydrolase activity, and histopathology of the granulation tissue were also analyzed. The antioxidant status during wound healing was monitored continuously for 14 days. RESULTS: VCO-treated wounds healed much faster, as indicated by a decreased time of complete epithelization and higher levels of various skin components. Pepsin-soluble collagen showed a significant increase in VCO- treated wounds, indicating a higher collagen cross-linking. Glycohydrolase activities were also found to be increased due to a higher turnover of collagen. Antioxidant enzyme activities, and reduced glutathione and malondialdehyde levels were found to be increased on the 10th day after wounding, which were found to have returned to normal levels on day 14 in the treated wounds. The lipid peroxide levels were found to be lower in the treated wounds. A histopathological study showed an increase in fibroblast proliferation and neovascularization in VCO-treated wounds compared to controls. CONCLUSION: The beneficial effect of VCO can be attributed to the cumulative effect of various biologically active minor components present in it.

[Effects of mild moxibustion on angiogenesis and microcirculation in wound repair after operation of anal fistula in rats].

OBJECTIVE: To observe the effects of mild moxibustion on angiogenesis and microcirculation in wound repair after operation of anal fistula, and to explore the mechanism of action. METHODS: Seventy-two SD male rats were made to bear an "acute, open, bleeding, infected" wound surface and were divided randomly into mild moxibustion group, microwave group and control group (24 rats per group). The wound surfaces of the treatment groups were treated for 15 min with mild moxibustion or microwave medical instrument from the first day after operation, and the control group was not given any treatment. At the first, third, seventh and fourteenth days after operation (1, 3, 7 and 14 days of treatment), six rats in each group were sacrificed after examining the blood flow of the wound surface, and the samples of granulation tissues were collected. The numbers of CD34 and positive expression of vascular endothelial growth factor (VEGF) in granulation tissues were detected. RESULTS: In the early and middle stages of wound healing, mild moxibustion could obviously increase the expression of VEGF, the number of CD34, and the blood flow of the wound surface. And the expression of VEGF, the number of CD34, and the blood flow of the wound surface began to increase at the third day, and reached the peak level at the seventh day, and then began to decrease. In the late stage of wound healing (day 14), mild moxibustion could decrease the expression of VEGF, the number of CD34, and decrease the blood flow of the wound surface. There were significant differences between the mild moxibustion group and the control group in the blood flow of the wound surface, the expression of VEGF and the numbers of CD34 in granulation tissues (P<0.05) after treatment, and except the number of CD34 at 14-day treatment, there were also differences between the mild moxibustion group and the microwave group. CONCLUSION: Mild moxibustion has better regulative actions on blood flow of the wound surface and the number of CD34 and positive expression of VEGF in granulation tissues, and can regulate microcirculation in wound surface and promote the wound healing.

[Effects of Fuhuang Shengji Yuchuang Ointment on expressions of types I and III collagens in granulation tissue of wound in rats with diabetes].

OBJECTIVE: To observe the effects of Fuhuang Shengji Yuchuang (FHSJYC) Ointment, a compound traditional Chinese herbal medicine, on the expressions of types I and III collagens in granulation tissue of wound in rats with diabetes. METHODS: Fifty-four male Wistar rats were randomly divided into three groups: wound control group, normal saline (NS) group and FHSJYC Ointment group. Diabetes was induced by injection of 1.5% alloxan and oral gavage of 5% glucose, and skin wound was made in rats of the NS group and the FHSJYC Ointment group. Skin wounds of the rats in the FHSJYC Ointment group were treated with FHSJYC Ointment gauze dressing, while those in the NS group were treated with NS gauze dressing once daily. The rats were executed in turn on the third day and the eleventh day of the treatment, and the changes of the content of types I and III collagens in the wound granulation tissue were observed by immunohistochemical technology. RESULTS: Compared with the NS group, the wound closure index in the FHSJYC Ointment group was increased (P<0.05). After 3-day treatment, the expression of type I collagen showed no significant differences among the three groups, while the expression of type III collagen in the FHSJYC Ointment group was higher than that in the NS group (P<0.05), similar with that in the wound control group. After 11-day treatment, the expressions of both types I and type III collagens in the FHSJYC Ointment group were higher than those in the NS group (P<0.05), similar with those in the wound control group. CONCLUSION: FHSJYC Ointment can affect the process of wound healing by promoting and regulating the expressions of types I and III collagens.

[Effects of Shibao Powder on promoting the expression of b-FGF and TGF-beta 1, in the repair of soft tissue injuries].

OBJECTIVE: To study the effects of Shibao Powder on the expression of b-FGF and TGF-beta 1 in granulation tissues of rabbit models with soft tissue injuries, so as to explore mechanism of external Chinese drugs for repairing of soft tissues in molecular levels. METHODS: The rabbit models were established by classical method of full-thickness skin wounds. After 8% sodium sulfide was used and routine disinfection completed, intra-peritoneal anaesthesia was adopted. The skin was cut to expose gastrocnemius muscle, and imcomplete sharp dissection was made near the tendon insertion. The length of the incision was 0.8 cm and the width was 0.4 cm. The rabbits in the experimental group were treated with spread of Shibao Powder at the wound; the rabbits in clean group were treated with routine dressing changes and disinfection; and the rabbits in the control group were treated with dressing changes only. The granulation tissues in different stages were collected and observed with high power microscope. The expression of Transforming Growth Factor-beta 1 (TGF-beta 1) protein and b-FGF protein in wound tissues were detected using StreptA-ridin-Biotin-Complex (SABC) method. RESULTS: The results showed that the expression of b-FGF protein had significant differences among 3 groups at the 6th day after trauma (P<0.05). The TGF-beta 1 protein expression also had significant differences among 3 groups at the 10th and 14th days after trauma (P<0.05). At the same time, the growth states of granulation tissues had difference among 3 groups at the same trauma stage, and within the same group among different trauma stages. CONCLUSION: This experimental study shows that Shibao Powder is effective to promote the repair of soft tissues after trauma by stimulating production of endogenous growth factor from cells in wound.

Triphala promotes healing of infected full-thickness dermal wound.

BACKGROUND: Infection is a major problem in the management of wounds. Even though the development of synthetic antimicrobial agents persists, drug resistance and toxicity hinder their way. Many plants with multi-potent pharmaceutical activities may offer better treatment options, and Triphala (dried fruits of Terminalia chebula, Terminalia bellirica, and Phyllanthus emblica) are potential formulations evaluated for healing activity on infected wound as it possesses numerous activities. MATERIALS AND METHODS: Alcoholic extract of Triphala has shown in vitro antimicrobial activity against wound pathogens such as Staphylococcus aureus, Pseudomonas aeruginosa, and Streptococcus pyogenes. An ointment was prepared from the Triphala extract (10% w/w) and assessed for in vivo wound healing on infected rat model by rate of healing, bacterial count, biochemical analysis, and expression of matrix metalloproteinases. RESULTS: The treated group has shown significantly improved wound closure. Assessment of granulation tissue on every fourth day showed significant reduction in bacterial count with significant level of collagen, hexosamine, uronic acid, and superoxide dismutase in the treated group (P < 0.01). Reduction of matrix metalloproteinase expression observed in the treated group by gelatin zymography and immunoblotting confirms our in vivo assessment. CONCLUSIONS: The above results showed the antibacterial, wound healing, and antioxidant activities of Triphala ointment, necessary for the management of infected wounds. Active principles of the Triphala may be further evaluated and used as an excellent therapeutic formulation for infected wounds.

[Effects of resolving stagnation and promoting granulation therapy on expressions of Bax and Bcl-2 in granulation tissue of diabetic rats during wound healing].

OBJECTIVE: To study the effects of resolving stagnation and promoting granulation therapy on expressions of Bax and Bcl-2 in granulation tissue of diabetic rats during wound healing. METHODS: Seventy-two male SD diabetic rats with full-thickness skin lesion were randomly divided into 3 groups: SJHYR 1-treated group, SJHYR 2-treated group and normal saline (NS) control group. SJHYR 1 was prepared with Shengji Recipe (SJR, a compound traditional Chinese herbal medicine for promoting granulation) and Huayu Recipe (HYR, a compound traditional Chinese herbal medicine for resolving stagnation) at a ratio of 1:2, while SJHYR 2 was prepared with SJR and HYR at a ratio of 1:1. Immunohistochemical method was used to assess Bax and Bcl-2 protein levels in granulation tissue. RESULTS: SJHYR 1 could accelerate wound healing as compared with SJHYR 2 and NS (P<0.05). On the third day in experiment, Bax and Bcl-2 proteins were not found in any groups, but on the seventh and eleventh day in experiment, Bax and Bcl-2 proteins in SJHYR 1-treated group were much higher than those in the other two groups (P<0.05). CONCLUSION: SJR and HYR in different ratios may all have a role in regulating Bax and Bcl-2 expression in granulation tissue of diabetic rats during wound healing.

[Influence of stasis-removing and muscle-regenerating Chinese hebal medicine on the expression of collagen type I and matrix metalloproteinase-1 in granulation tissue of ordinary wound].

OBJECTIVE: To understand the effects of Chinese herbal medicine for stasis -removing (SR) and muscle-regenerating (MR), in different constitutions, on granulation tissue of ordinary wound. METHODS: Shengji Huayu recipe, a common used Chinese recipe for SR & MR (SR-MR), and its disassembled recipe, Shengji recipe (MR) and Huayu recipe (SR), were applied resectively on the full-layer skin injured wound in 120 rats to observe their effects on collagen type I (C I ) and matrix metalloproteinase-1 (MMP-1) in granulation tissue of wound at various stages of healing with immunohistochemistry technique and image-analysis system. RESULTS: The expression of C I of the normal group was obviously delayed and the level of MMP-1 increased in a ladder type from day 3 to day 11. Shengji group could promote the secretion of C I and MMP-1 at the early stage and keep a high level from day 3 to day 11. The expression of MMP-1 of Huayu group maintained a high level on the first 7 days with significant difference as compared with the Shengji group (P < 0.05), and reduced from day 11 showing significant difference when compared with the normal group and Shengji group (all P < 0.05). Shengji Huayu low dose group has two periods of peak time in promoting the secretion of C I on day 7 and 15, and showed significant difference as compared with the normal group (P < 0.05); Shengji Huayu high dose group could reduce the MMP-1 on day 11 and obviously lower when compared with the normal group (P<0.05). CONCLUSION: The mechanism of Chinese herbal medicine for SR-MR in promoting wound healing was probably through inhibiting the secretion of MMP-1 to increase the C I content in granulation tissue of wound.

Evaluation of Tectona grandis leaves for wound healing activity.

The frontal leaves of Tectona grandis (Verabinaceae) are widely used in the folklore for the treatment of various kinds of wounds, especially burn wound. The present study was carried out to evaluate the effect of hydrochloric extract of Tectona grandis on experimentally induced wounds in rats and compare the effects observed with a known wound healing agent, Aloe vera. The models selected were excision wound, incision wound, burn wound and dead space wound. A suitable gel formulation was selected for the application using cellophane membrane penetration. In the excision wound and burn wound models, animals treated with Tectona grandis leaf extract showed significant reduction in period of epithelisation and wound contraction 50%. In the incision wound model, a significant increase in the breaking strength was observed. Tectona grandis leaf extract treatment orally produced a significant increase in the breaking strength, dry weight and hydroxyproline content of the granulation tissue in dead space wound. It was concluded that Tectona grandis leaf extract applied topically (5% and 10% gel formulation) or administered orally (250 mg and 500 mg/kg body weight) possesses wound healing activity.