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Introdução: A fitoterapia se baseia na utilização de plantas medicinais, através de diferentes formulações farmacêuticas com fins terapêuticos. Na Odontologia, os fitoterápicos têm sido alvo de estudos, devido suas propriedades benéficas, além de apresentarem biocompatibilidade, baixo custo e fácil acesso. Objetivo: Realizar um levantamento na literatura científica sobre a utilização da fitoterapia na Odontologia, com vistas aos efeitos antimicrobiano, anti-inflamatório e reparador. Material e Métodos: A busca ocorreu entre fevereiro a julho/2023, nas bases PubMed e LILACS, além de livre busca, cruzando-se os descritores "Phytotherapy", "Dentistry", "Anti-inflamatory Agents", "Anti-Infective Agents", "Wound Healing", "Fitoterapia", "Odontologia", "Anti-inflamatório", "Antimicrobiano" e "Cicatrização". Após leitura inicial, seguida da análise crítica com aplicação dos critérios estabelecidos, foram selecionadas 50 referências. Desenvolvimento: Diversas plantas são empregadas sob a forma de fitoterapia, como Aloe vera (babosa), Matricaria recutita (camomila), Copaifera (copaíba), Punica granatum (romã), Uncaria tomentosa (unha-de-gato), Malva sylvestris (malva), Althaea officinalis (malvaísco), Myracrodruon urundeuva (Aroeira), Lippia sidoides (Alecrim pimenta) e Glycyrrhiza glabra (Alcaçuz). Na Odontologia, pesquisas evidenciaram resultados satisfatórios para o tratamento de afecções da cavidade oral, especialmente com caráter inflamatório e infeccioso, além de aclerar a cicatrização. Esses achados apontam que a fitoterapia é um tratamento eficaz, acessível e com mínimos efeitos colaterais. Considerações finais: Com base na literatura revisada, a fitoterapia parece ser uma alternativa promissora no tratamento de afecções orais, devido aos seus notáveis efeitos cicatrizantes, antimicrobianos e anti-inflamatórios. Contudo, mais pesquisas com metodologias adequadas são necessárias para que se estabeleçam protocolos clínicos seguros e eficazes.
Introduction: Phytotherapy is based on the use of medicinal plants through different pharmaceutical formulations for therapeutic purposes. In Dentistry, phytotherapeutics have been the subject of studies due to their beneficial properties, as well as their biocompatibility, low cost, and easy accessibility. Objective: To conduct a literature review on the use of phytotherapy in Dentistry, focusing on antimicrobial, anti-inflammatory, and reparative effects. Materials and Methods: The search took place between February and July 2023, using PubMed and LILACS databases, in addition to a free search, crossing the descriptors "Phytotherapy," "Dentistry," "Anti-inflammatory Agents," "Anti-Infective Agents," "Wound Healing," "Fitoterapia," "Odontologia," "Anti-inflammatory," "Antimicrobial," and "Cicatrização." After an initial reading, followed by critical analysis with the application of established criteria, 50 references were selected. Development: Various plants are employed in phytotherapy, such as Aloe vera (aloe), Matricaria recutita (chamomile), Copaifera (copaiba), Punica granatum (pomegranate), Uncaria tomentosa (cat's claw), Malva sylvestris (mallow), Althaea officinalis (marshmallow), Myracrodruon urundeuva (Brazilian copaiba), Lippia sidoides (rosemary pepper), and Glycyrrhiza glabra (licorice). In Dentistry, research has shown satisfactory results for the treatment of oral cavity conditions, especially those with inflammatory and infectious characteristics, as well as accelerating healing. These findings suggest that phytotherapy is an effective, accessible treatment with minimal side effects. Final considerations: Based on the reviewed literature, phytotherapy appears to be a promising alternative in the treatment of oral conditions due to its notable healing, antimicrobial, and anti-inflammatory effects. However, more research with appropriate methodologies is necessary to establish safe and effective clinical protocols.
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Terapêutica , Cicatrização , Odontologia , Fitoterapia , Anti-Inflamatórios , BocaRESUMO
Diabetes mellitus is associated with chronic wound-healing problems that significantly impact patients' quality of life and substantially increase expenditure on healthcare. Therefore, the identification of compounds that can aid healing is justified. Anredera cordifolia (Ten.) has been used in folk medicine for curative purposes; however, the causal mechanisms underlying its healing effects remain to be elucidated. In this study, the effect of the ethanolic extract of A. cordifolia was evaluated in an in vitro healing model using fibroblasts cultivated under normoglycemic and hyperglycemic environments. The extract was predominantly composed of phytol and exhibited genoprotective activity. Fibroblast migration attenuated the adverse effects of hyperglycemia, favoring cell proliferation. Collagen levels were significantly increased in ruptured fibroblasts under both standard and hyperglycemic environments. The phytogenomic effect of the extract on three genes related to extracellular matrix formation, maintenance, and degradation showed that A. cordifolia increased the expression of genes related to matrix synthesis and maintenance in both normoglycemic and hyperglycemic individuals. Furthermore, it reduced the expression of genes related to matrix degradation. Overall, this is the first study to demonstrate the effectiveness of A. cordifolia in wound healing, elucidating possible causal mechanisms that appear to be based on the genoprotective effect of this plant on the migratory and proliferative phases of the wound healing process; these effects are probably related to phytol, its main constituent.
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Movimento Celular , Proliferação de Células , Fibroblastos , Hiperglicemia , Extratos Vegetais , Cicatrização , Proliferação de Células/efeitos dos fármacos , Movimento Celular/efeitos dos fármacos , Extratos Vegetais/farmacologia , Fibroblastos/efeitos dos fármacos , Fibroblastos/metabolismo , Cicatrização/efeitos dos fármacos , Humanos , Hiperglicemia/tratamento farmacológico , Etanol/química , Diabetes Mellitus/tratamento farmacológicoRESUMO
BACKGROUND Managing unique anatomical structures, such as the nasopalatine canal, remains key for successful implant placement and long-term functionality. Topical oral oxygen therapy (TOOT) has gained attention for its antibacterial, regenerative properties, and ability to accelerate wound healing. This report presents a case of postoperative palatal necrosis successfully treated with TOOT oxygen-active gel (blue®m) CASE REPORT A 33-year-old male patient presented with the primary concern of needing rehabilitation of the anterior maxillary region. Clinical and imaging examinations revealed a deficient maxillary ridge and an enlarged incisive foramen. The treatment plan involved nasopalatine deflation with guided bone regeneration using particulate synthetic bone graft and a collagen membrane. Seven days after surgery, he returned with minimal pain but had necrotic tissue on the palate. The necrotic tissue and a portion of the contaminated biomaterial were removed, and the area was thoroughly cleansed with a saline solution. A thick layer of active oxygen gel (blue®m) was then applied to the palatal lesion. The patient was instructed to apply the gel 3 times daily for 30 days and attended follow-up appointments every 2 days. After 12 days, rapid healing and significant clinical improvement were observed, with the patient reporting no pain or sensitivity. By day 34, the lesion had fully closed, and re-epithelialization was achieved. CONCLUSIONS Our patient had complete resolution of palatal necrosis after nervus deflation using TOOT with active oxygen gel (blue®m), and this therapy seemed to accelerate the healing process.
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Géis , Necrose , Humanos , Masculino , Adulto , Cicatrização , Palato , Oxigênio/uso terapêuticoRESUMO
Wound healing is a complex and coordinated process involving interactions between cells and various messenger systems. This study conducted in vivo tests to determine the healing effect of propolis (PR)-based cream derived from the Amazon stingless bee, Scaptotrigona aff. postica, reared in açaí (Euterpe oleracea) monoculture, on induced wounds in rats. Data were obtained by monitoring injuries on 14 Wistar rats, divided into three groups (G1, G2 and G3), each receiving specific treatments: propolis-based cream (PR), collagenase (PC) and neutral cream (NC). Over the seven days of treatment, the lesions were measured using photographic records and ImageJ software to evaluate the healing effectiveness of the test cream. ImageJ software version 1.53g was used to compare the wound diameters for each treatment. After seven days, histopathological analyses of the induced lesions were performed. It was observed that collagenase (PC) and the test cream (PR) did not differ significantly in terms of wound diameter reduction. However, the propolis-based cream directly influenced the lesion maturation process and exhibited a milder inflammatory response compared to the positive control (PC). This effect is possibly associated with antimicrobial and anti-inflammatory compounds identified by GC/MS analysis in the propolis. Notably, this is the first report describing propolis of Scaptotrigona aff. postica obtained from açaí monocultures with strong healing potential, highlighting the identification of a high concentration of phenolic compounds that aid directly in wound repair.
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Euterpe , Própole , Ratos Wistar , Cicatrização , Animais , Própole/farmacologia , Própole/química , Cicatrização/efeitos dos fármacos , Ratos , Abelhas , Euterpe/química , Masculino , Colagenases/metabolismoRESUMO
PURPOSE: This study aimed to evaluate the effects of ozone therapy applied topically and/or by bagging on the healing of clean wounds induced in rat's skin. METHODS: One hundred and twenty male rats of about 16 weeks old was divided into five groups: G1) saline solution (0.9%); G2) sunflower oil; G3) ozonated sunflower oil; G4) ozone bagging; G5) association of ozonated sunflower oil and ozone bagging. The wounds were evaluated through macroscopic, morphometric, histopathologic, and tensile strength analyses. RESULTS: Analysis among groups showed a lower percentage of wound contraction in G1 compared to G4 only in M7D. The tensile strength of the wounds showed differences among groups in the seventh (M7D) and the 14th (M14D) postoperative day, and among time points in G1 (M14D > M7D). The elongation of the wounds showed differences in G3 (M7D > M14D). Histological evaluation of the wounds showed significant change in bleeding, mixed to mononuclear infiltrate, congestion, and tissue disorganization for tissue organization between groups and time points. CONCLUSIONS: Ozone therapy applied topically and/or by bagging was not deleterious to the healing of clean wounds induced in rat's skin, but ozone bagging showed the best contribution to the healing process.
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Ozônio , Ratos Wistar , Pele , Resistência à Tração , Cicatrização , Animais , Ozônio/administração & dosagem , Ozônio/uso terapêutico , Ozônio/farmacologia , Cicatrização/efeitos dos fármacos , Masculino , Pele/lesões , Pele/efeitos dos fármacos , Pele/patologia , Ratos , Resistência à Tração/efeitos dos fármacos , Óleo de Girassol , Administração Tópica , Fatores de Tempo , Resultado do Tratamento , Modelos Animais de Doenças , Reprodutibilidade dos TestesRESUMO
BACKGROUND: Cadaveric skin grafts were initially used for the management of acute burn wounds. The biological coverage of the wound improves the quality of the wound bed, which prepares it to receive an autologous skin graft. The benefits of cadaveric skin graft in burn wounds have led to its use in the management of acute and chronic wounds of diverse etiologies. OBJECTIVE: To evaluate the use of cadaveric skin graft and subsequent autologous split-thickness skin graft (STSG) in the management of wounds of diverse etiologies at a single institution. MATERIALS AND METHODS: A retrospective analysis was performed of patients with wounds of different etiologies managed with cadaveric skin grafts followed by a second procedure in which autologous STSG was performed from May 2017 through May 2022 in the Plastic and Reconstructive Surgery Department of German Hospital, Buenos Aires, Argentina. RESULTS: A total of 25 patients with wounds of different etiologies were included. The mean affected body surface area (BSA) was 1.87%. The mean engraftment percentage of the cadaveric skin graft was 96.6%. The mean engraftment percentage of the STSG was 90.6%. All patients demonstrated improvement in local edema and inflammation, reduced secretions, and reduced pain after treatment. Two patients (8%) had complications, with 1 case of delayed healing of the donor site and 1 case of hypertrophic scarring. CONCLUSIONS: Cadaveric skin graft with subsequent STSG is a simple, safe, and effective alternative for the management of complex wounds of diverse etiologies. This technique is particularly useful in patients with multiple comorbidities who are at risk of recurrence and of developing multiple wounds during their lifetime.
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Cadáver , Transplante de Pele , Cicatrização , Humanos , Transplante de Pele/métodos , Estudos Retrospectivos , Masculino , Feminino , Cicatrização/fisiologia , Pessoa de Meia-Idade , Idoso , Adulto , Transplante Autólogo , Ferimentos e Lesões/cirurgia , Ferimentos e Lesões/terapia , Resultado do Tratamento , Queimaduras/terapia , Queimaduras/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Idoso de 80 Anos ou maisRESUMO
Assessing the responses to the application of photobiomodulation using red and infrared spectrum light-emitting diodes (LED) on diabetic foot ulcers. Diabetic volunteers, of both genders, aged between 30 and 65 years, with grade I or II ulcers, were randomized into the groups: red LED, infrared LED, LED associated, and control. Home-based interventions took place on a daily basis for 12 weeks. Assessments of sample characterization were performed on day 1 and 90, and the variables wound healing index, mean skin temperature, sensitivity and pain in the wound area were measured at the pre-intervention time on days 1, 30, 60 and 90, with subsequent follow-up 30 days after the end of treatment. For statistical analysis, the software SPSS, version 17.0, intention-to-treat analysis, data normality was tested, and the linear mixed effects model, with a significance level of 5%. Magnitudes of clinical effect by Cohen's d. At the pre vs post intervention time of 90 days, we found a large clinical effect of G-LED V (d=1.7) and G -LED IV (d=1.6) in relation to G-C, where these intervention groups showed a tendency for faster wound healing compared to G-C. We also observed small clinical effect of G-LED IV, which showed greater reduction in the area in relation to G-LED V (d=0.4) and G-LED A (d=0.3). Conclusion: The use of individually applied red and infrared LED phototherapy clinically tended to be more effective for the reduction of diabetic foot ulcer areas, and infrared LED was the most effective. Trial registration: NCT03250533 (clinicaltrials.gov).
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Pé Diabético , Raios Infravermelhos , Terapia com Luz de Baixa Intensidade , Cicatrização , Humanos , Pé Diabético/radioterapia , Pé Diabético/terapia , Pessoa de Meia-Idade , Feminino , Cicatrização/efeitos da radiação , Masculino , Terapia com Luz de Baixa Intensidade/métodos , Terapia com Luz de Baixa Intensidade/instrumentação , Raios Infravermelhos/uso terapêutico , Adulto , Idoso , Resultado do Tratamento , Temperatura Cutânea/efeitos da radiaçãoRESUMO
In recent years, systemic inflammation has emerged as a pivotal player in the development and progression of various degenerative diseases. This complex, chronic inflammatory state, often undetected, can have far-reaching consequences for the body's physiology. At the molecular level, markers such as C-reactive protein, cytokines and other inflammatory mediators serve as indicators of systemic inflammation and often act as predictors of numerous musculoskeletal diseases and even certain forms of cancer. The concept of 'meta-inflammation', specifically referring to metabolically triggered inflammation, allows healthcare professionals to understand inflammatory responses in patients with metabolic syndrome. Driven by nutrient excess and the expansion of adipose tissue, meta-inflammation is closely associated with insulin resistance, further propagating the metabolic dysfunction observed in many Western societies. Wound persistence, on the other hand, exacerbates the detrimental effects of prolonged inflammation at the local level. Acute inflammation is a beneficial and essential process for wound healing and infection control. However, when inflammation fails to resolve, it can impede the healing process, leading to chronic wounds, excessive scarring and even the activation of fibrotic pathways. This approach significantly reduces the efficacy of regenerative biological therapies. Our review focuses on the vital role of proteins, vitamins and minerals in collagen synthesis and cell proliferation for tissue healing. We also examine hormonal influences on regeneration, noting the negative effects of imbalances, and emphasize glucose regulation's importance in creating a stable environment for chronic wound healing.
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Inflamação , Doenças Musculoesqueléticas , Cicatrização , Humanos , Cicatrização/fisiologia , Doenças Musculoesqueléticas/metabolismo , Doenças Musculoesqueléticas/fisiopatologia , Doença Crônica , Inflamação/metabolismo , Ferimentos e Lesões/metabolismo , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Síndrome Metabólica/metabolismoRESUMO
Dressings should protect wounds, promote healing, absorb fluids, and maintain moisture. Bacterial cellulose is a biopolymer that stands out in biomaterials due to its high biocompatibility in several applications. In the area of dressings, it is already marketed as an alternative to traditional dressings. However, it lacks any intrinsic activity; among these, the need for antimicrobial activity in infected wounds stands out. We developed a cationic cellulose film by modifying cellulose with 1-(5-carboxypentyl)pyridin-1-ium bromide, enhancing its wettability (contact angle: 26.6°) and water retention capacity (2714.37 %). This modified film effectively retained oxacillin compared to the unmodified control. Liposomal encapsulation further prolonged oxacillin release up to 11 days. Both oxacillin-loaded films and liposomal formulations demonstrated antimicrobial activity against Staphylococcus aureus. Our findings demonstrate the potential of chemically modified cellulose as a platform for controlled anionic antibiotics and/or their formulations delivery in wound care.
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Antibacterianos , Bandagens , Celulose , Preparações de Ação Retardada , Liberação Controlada de Fármacos , Lipossomos , Oxacilina , Staphylococcus aureus , Celulose/química , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos/química , Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Oxacilina/administração & dosagem , Oxacilina/farmacologia , Oxacilina/química , Cátions/química , Ânions/química , Cicatrização/efeitos dos fármacos , MolhabilidadeRESUMO
OBJECTIVE: to assess the effectiveness of 5% Brazilian green propolis (ointment) in individuals with chronic ulcers. METHODS: a randomized clinical trial, developed with 40 patients randomized equally to control group (treated with essential fatty acid) and experimental group (treated with 5% green propolis) for 30 days. The outcomes of interest were sociodemographic, clinical and laboratory characteristics, lesion characteristics, such as type of tissue in the bed, presence of exudate, edge characteristics, microbial content and pain. RESULTS: regarding sociodemographic, clinical and laboratory characteristics, the two groups did not show statistically significant differences. After assessment in 30 days, an effect was observed for both treated groups, but for the experimental group, greater effectiveness in terms of the type of tissue in the bed, type of exudate, edge characteristics, microbial content and pain. CONCLUSION: propolis-based ointment showed a healing effect, presenting itself as a potential tool in healing chronic ulcers.
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Própole , Humanos , Própole/uso terapêutico , Própole/farmacologia , Feminino , Masculino , Pessoa de Meia-Idade , Brasil , Idoso , Doença Crônica/tratamento farmacológico , Cicatrização/efeitos dos fármacos , Resultado do Tratamento , AdultoRESUMO
Herein, four different grafted chitosans were synthesized by covalent attachment of glycine, L-arginine, L-glutamic acid, or L-cysteine to the chitosan chains. All products were subsequently permethylated to obtain their corresponding quaternary ammonium salts to enhance the inherent antimicrobial properties of native chitosan. In all cases, transparent hydrogels with the following remarkable characteristics were obtained: i) high-water absorption capacity (32-44 g H2O per g of polymer), ii) viscoelastic behavior at low deformations, iii) flexibility when subjected to deformations and iv) stability over long time scales. All the permethylated derivatives successfully inhibited 100 % of the growth of S. aureus. They also exhibited higher antimicrobial activity against E. coli than native chitosan. The structure of the chemically crosslinked products was more stable under external perturbations than that of the physically crosslinked ones. Between the chemically crosslinked products, the permethylated glutamic acid-grafted chitosan exhibited a noteworthy higher water absorption capacity with respect to that modified with cysteine, which makes it the most promising material for various industrial applications, including biomedical and food industries. Regarding biomedical applications, this derivative met the required physicochemical criteria for wound dressings, which encourages the pursuit of biological studies necessary to ensure the safety of its use for this application.
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Bandagens , Quitosana , Hidrogéis , Quitosana/química , Quitosana/farmacologia , Hidrogéis/química , Hidrogéis/farmacologia , Hidrogéis/síntese química , Escherichia coli/efeitos dos fármacos , Escherichia coli/crescimento & desenvolvimento , Antibacterianos/farmacologia , Antibacterianos/química , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/crescimento & desenvolvimento , Água/química , Cicatrização/efeitos dos fármacos , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologiaRESUMO
Pre-clinical assays demonstrated that a 1% polyvinyl alcohol biomembrane containing latex proteins (10%) from the medicinal plant Calotropis procera was biocompatible and stimulated healing of incisional and excisional wounds in murine models, and the mechanistic aspects were established. The efficacy of the biomembrane (BioMemCpLP) to promote healing of chronic ulcers in leprosy patients was investigated. The study started with 28 volunteers. Five were excluded later due to different disconformities. Ulcers from 15 patients were continuously treated with BioMemCpLP for 56 days. Five patients were treated only with silver sulfadiazine and three patients received plain hydrocolloid wound dressings with high absorption capacity. In all cases, wound dressings were renewed three times a week for 56 days and ulcers were evaluated weekly for contraction and healing progress. The extent of the healed area in the ulcers treated with BioMemCpLP was greater than in the control groups. Approximately 88% of ulcers treated with BioMemCpLP were fully healed before day 56, against 6% in both control groups. This result was not correlated with age/gender, duration or location of ulcers, deformity or whether or not the patient was cured of leprosy. The results showed that BioMemCpLP was beneficial for treatment of ulcers suffered by leprosy patients without noticeable side effects.
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Calotropis , Látex , Hanseníase , Cicatrização , Calotropis/química , Feminino , Masculino , Cicatrização/efeitos dos fármacos , Humanos , Látex/química , Pessoa de Meia-Idade , Adulto , Hanseníase/complicações , Hanseníase/tratamento farmacológico , Proteínas de Plantas/administração & dosagem , Proteínas de Plantas/farmacologia , Doença Crônica , Úlcera do Pé/tratamento farmacológico , Úlcera do Pé/etiologia , Idoso , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Percutaneous Achilles tendon (AT) repair with the Dresden instrument is a safe and effective treatment for AT rupture within 15 days after injury. Follow-up includes clinical examination and imaging to assess the healing process and detect possible complications. The findings of each control visit determine the progression of the rehabilitation of each patient. METHODS: We assessed the postoperative findings of all patients who underwent AT with the Dresden technique from May 2022 to September 2023, during a follow-up period of 6 months. The study population included 40 male patients between 18 and 59 years of age. Ultrasound (US) and magnetic resonance imaging (MRI) were performed in all patients at day 15 postoperatively and then monthly for 6 months. RESULTS: All patients completed 6 months follow-up and 2 (5%) presented with postoperative wound dehiscence. No sural nerve lesions, reruptures, reoperations or other complications were seen. Both imaging methods showed excellent correlation of findings at all time points. Both methods were effective to assess the hematoma and structural changes of the healing process during the first 3 months. The use of US with Doppler was a useful tool to evaluate blood flow to the tendon stumps. After 3 months no significant morphological changes were observed but the US enabled a dynamic functional assessment of the tendon. After 4 months tissues showed homogenization and decrease of volume without further major changes. CONCLUSION: Both US and MRI proved to be excellent methods to assess the healing process after percutaneous AT repair. The US performed by an experienced investigator showed advantages over MRI in evaluating the gap between the tendon stumps, the possibility of evaluating the vascularity with Doppler US and assessing the functionality of the healing tendon with dynamic examination, besides being a cheap and easily accessible imaging method.
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Tendão do Calcâneo , Imageamento por Ressonância Magnética , Traumatismos dos Tendões , Ultrassonografia , Cicatrização , Humanos , Tendão do Calcâneo/lesões , Tendão do Calcâneo/diagnóstico por imagem , Tendão do Calcâneo/cirurgia , Masculino , Imageamento por Ressonância Magnética/métodos , Adulto , Pessoa de Meia-Idade , Traumatismos dos Tendões/diagnóstico por imagem , Traumatismos dos Tendões/cirurgia , Adolescente , Ultrassonografia/métodos , Adulto Jovem , Ruptura/cirurgia , Ruptura/diagnóstico por imagem , Resultado do TratamentoRESUMO
OBJECTIVE: To analyze the effect of Unna's Boot on the healing of venous ulcers compared to other therapies. METHODS: Systematic Review carried out in the databases Scopus, Embase, Cochrane Library, Web of Science, PubMed, Cumulative Index of Nursing and Allied Health Literature, Latin American and Caribbean Literature in Health Sciences, and grey literature. Population - adult patients with venous ulcers; Intervention- Unna's Boot (UB); Control - other compression therapies (CT); Outcome- healing; Designs- randomized clinical trial, cohort study, and case control, published from 2001 to 2024. The effect of the intervention, risk of bias, and quality of evidence were evaluated. Registered with PROSPERO (CRD42021290077). RESULTS: A total of 39 studies were included, with 5.151 patients. The majority (71.8%) were randomized controlled trials (RCT). UB was used as intervention/control in eight studies. When comparing CTs, only 1 study with UB showed a superior effect (p < .001) in healing, compared with high compression elastic bandage. In the quality of evidence analysis, 27 studies were assessed as having a high risk of bias. CONCLUSION: No superiority of UB was found in the healing of venous ulcers when compared to other CTs.
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Úlcera Varicosa , Cicatrização , Humanos , Bandagens Compressivas , Ensaios Clínicos Controlados Aleatórios como Assunto , Úlcera Varicosa/terapiaRESUMO
Royal sun medicinal mushroom Agaricus brasiliensis KA21 has various beneficial pharmacological effects; however, these effects are influenced by its cultivation conditions. A. brasiliensis KA21 is rich in ß-glucan, which promotes wound healing. This study evaluated the wound healing-promoting effects of A. brasiliensis KA21 and the influence of cultivation conditions on these effects. Upon evaluation of its effect on wound healing, the outdoor-cultivated A. brasiliensis KA21 (KAOD) promoted wound healing in mice, and the effect of KAOD was stronger than that of the indoor-cultivated one (KAID). In addition, A. brasiliensis KA21 promoted the synthesis of collagen I and III, which are involved in promoting wound healing; KAOD strongly induced collagen III production. Furthermore, KAOD suppressed the decrease in skin elasticity after acetone application in our mouse model, which was not observed for KAID. These results show that KAOD is useful as a supplement in surgery and injury healing for humans and animals, improving immunity against pathogens in wound areas and promoting wound healing. In addition, KAOD may be useful in the field of skin aesthetics for repairing skin damage and maintaining skin elasticity.
Assuntos
Agaricus , Pele , Cicatrização , Animais , Cicatrização/efeitos dos fármacos , Agaricus/química , Camundongos , Pele/efeitos dos fármacos , Elasticidade/efeitos dos fármacos , Masculino , Humanos , Modelos Animais de DoençasRESUMO
BACKGROUND: Diabetic foot ulcers (DFUs) present devastating complications. Management of these wounds includes applying a vacuum device composed of a fenestrated tube embedded in a foam dressing and connected to a vacuum pump to collect the fluid in a vessel. OBJECTIVE: To review the effectiveness of negative pressure wound therapy (NPWT) in treating DFUs and evaluate the clinical outcomes of full and partial wound healing. METHODS: A systematic review and meta-analysis of randomized controlled trials was conducted after searching the PubMed, Web of Science, and Cochrane Library databases. Studies that described the use of NPWT in the management of DFUs were included and compared with different interventions for the proposed outcomes. RESULTS: A total of 14 studies were included, 1 of which was later excluded during internal validation. Wound healing outcomes were analyzed in 2 studies, showing the superiority of total wound healing in the NPWT group. Ten studies compared the effect of different interventions on wound area reduction and 8 of these results were best with NPWT. Three studies showed clinical and statistical homogeneity (I² = 100%), making it possible to conduct a meta-analysis. CONCLUSION: Although the articles included in this systematic review have limitations regarding methodological quality and clinical heterogeneity, the results showed the potential benefit of NPWT in healing and wound area reduction. These outcomes are essential in the prevention of amputation in patients with DFU.
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Pé Diabético , Tratamento de Ferimentos com Pressão Negativa , Cicatrização , Humanos , Pé Diabético/terapia , Tratamento de Ferimentos com Pressão Negativa/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Cicatrização/fisiologiaRESUMO
Chitosan chemical functionalization is a powerful tool to provide novel materials for additive manufacturing strategies. The main aim of this study was the employment of computer-aided wet spinning (CAWS) for the first time to design and fabricate carboxymethyl chitosan (CMCS) scaffolds. For this purpose, the synthesis of a chitosan derivative with a high degree of O-substitution (1.07) and water soluble in a large pH range allowed the fabrication of scaffolds with a 3D interconnected porous structure. In particular, the developed scaffolds were composed of CMCS fibers with a small diameter (< 60 µm) and a hollow structure due to a fast non solvent-induced coagulation. Zn2+ ionotropic crosslinking endowed the CMCS scaffolds with stability in aqueous solutions, pH-sensitive water uptake capability, and antimicrobial activity against Escherichia coli and Staphylococcus aureus. In addition, post-printing functionalization through collagen grafting resulted in a decreased stiffness (1.6 ± 0.3 kPa) and a higher elongation at break (101 ± 9 %) of CMCS scaffolds, as well as in their improved ability to support in vitro fibroblast viability and wound healing process. The obtained results encourage therefore further investigation of the developed scaffolds as antimicrobial wound dressing hydrogels for skin regeneration.
Assuntos
Antibacterianos , Bandagens , Quitosana , Escherichia coli , Staphylococcus aureus , Alicerces Teciduais , Cicatrização , Quitosana/química , Quitosana/análogos & derivados , Quitosana/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Alicerces Teciduais/química , Antibacterianos/farmacologia , Antibacterianos/química , Animais , Camundongos , Fibroblastos/efeitos dos fármacos , Porosidade , Sobrevivência Celular/efeitos dos fármacos , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Materiais Biocompatíveis/síntese química , Reagentes de Ligações Cruzadas/química , HumanosRESUMO
BACKGROUND: To verify the influence of macrogeometry with healing chambers on the osseointegration of dental implants by analyzing implant stability quotient (ISQ) and evaluate the correlation between insertion torque and ISQ insertion with different macrogeometries. METHODS: In total, 26 implants were installed in the posterior mandible of eight patients with sufficient bone height for the installation of implants measuring 3.5 mm in diameter and 9.0 mm in length. The implants were categorized according to two types of macrogeometry: a test group (GT) with 13 conical implants with healing chambers and a control group (GC) with 13 conical implants with conventional threads. To insert the implants, a bone drilling protocol was used up to a diameter of 3 mm with the last helical bur. The insertion torque of the implants was evaluated, followed by the measurement of ISQ at 0 (T-0), 7 (T-7), 14 (T-14), 21 (T-21), 28 (T-28), and 42 (T-42) days. RESULTS: The mean insertion torque was 43 Ncm in both groups, without a significant difference. Moreover, no significant difference in the ISQ values was found between the groups at different time points (p > 0.05), except at T-7 (GT = 69.87±1.89 and GC = 66.48±4.49; p = 0.01). Although there was no significant difference, ISQ median values were higher in the GT group than GC group at 28 days (GT = 67.98 and GC = 63.46; p = 0.05) and 42 days (GT = 66.12 and GC = 60.33; p = 0.09). No correlation was found between the insertion torque and ISQ insertion (p > 0.05). CONCLUSION: Furthermore, implants with a 3.5 mm diameter macrogeometry, with or without healing chambers, inserted with a drilling protocol up to 3 mm in diameter of the last helical bur, led to a similar secondary stability, with no difference in ISQ values. Although, implants with healing chamber demonstrates ascending values in the graph of ISQ, having a trend of faster osseointegration than implants without healing chambers. Both macrogeometries provide a similar primary stability to implants. TRIAL REGISTRATION: This study was registered retrospectively in ReBec (brazilian registry of clinical trials) under the number RBR-96n5×69, on the date of 19/06/2023.
Assuntos
Implantação Dentária Endóssea , Implantes Dentários , Mandíbula , Osseointegração , Torque , Humanos , Osseointegração/fisiologia , Implantação Dentária Endóssea/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Mandíbula/cirurgia , Planejamento de Prótese Dentária , Adulto , Cicatrização , Idoso , Retenção em Prótese Dentária , Propriedades de SuperfícieRESUMO
The development of new wound dressings made from biomaterials, which offer a better cost-benefit ratio and accelerate the healing process, is increasing nowadays. Various biopolymers can be electrospun to form functional membranes for wound healing. Therefore, in this study, chitosan and nanochitosan membranes with or without hyaluronic acid were prepared using the electrospinning technique, characterized and evaluated in the healing of skin wounds in rats. Chitosan and nanochitosan solutions, with or without hyaluronic acid, were prepared at concentrations of 1%-4% using PEO (polyethylene oxide) and subjected to the electrospinning process to obtain membranes characterized by scanning electron microscopy (SEM), mechanical tests, and antimicrobial activity. The healing effect of the membranes was evaluated by monitoring the area of the lesions, contraction of the wounds, histologic analysis, and induction of pro-inflammatory cytokine (IL-1 α and TNF-α) production in rats. The nanochitosan and nanochitosan membranes with hyaluronic acid achieved greater fiber diameter and uniformity, resistance, elasticity, and thermal stability, in addition to good adhesion to the wound bed and permeation capacity. Despite not presenting antimicrobial activity in vitro, they contributed to the production of pro-inflammatory interleukins in the animals tested, provided physical protection, reduced the wound area more markedly until the seventh day of the evaluation, with an acceleration of the healing process and especially when functionalized with hyaluronic acid. These results indicate that the membranes may be promising for accelerating the healing process of chronic wounds in humans.
Assuntos
Quitosana , Ácido Hialurônico , Membranas Artificiais , Pele , Cicatrização , Quitosana/química , Quitosana/farmacologia , Animais , Ácido Hialurônico/química , Ácido Hialurônico/farmacologia , Cicatrização/efeitos dos fármacos , Ratos , Pele/lesões , Pele/metabolismo , Masculino , Ratos Wistar , BandagensRESUMO
This study explored the effects of L-PRF on pain, soft tissue healing, periodontal condition, and post-extraction bone repair of mandibular third molars (3Ms). A randomized, prospective, triple-blind, split-mouth clinical trial was conducted with 34 volunteers. Eligible patients were randomly allocated into two treatments: G1 (without L-PRF), G2 (alveoli filled with L-PRF), in which the removal of bilateral 3Ms was performed at the same surgical time. Outcomes were assessed according to a visual analogue scale (pain), soft tissue scoring system (wound healing), periodontal probing of mandibular second molar. Bone repair was determined by volumetric analysis (ITK-SNAP software) and fractal analysis (ImageJ software). An intention-to-treat approach to Statistical analysis was used. L-PRF reduced pain in the 7-day postoperative follow-up (p = 0.019) and not only improved soft tissue healing after 1 month of follow-up (p = 0.021), but also probing depth (distal face) in 3 months postoperatively (p = 0.011). Significant alveolar reduction occurred in 3 months after surgery in both treatments (p < 0.05), however, this was more significant in G1 (p = 0.016). The fractal dimension showed no statistical differences. L-PRF improved postoperative clinical parameters of pain, soft tissue healing, and periodontal condition, suggesting that it has a beneficial effect on preserving the alveolar ridge and accelerating the initial repair process.