Abstract
Removal of necrotic tissue is essential for wound-bed preparation for the treatment of chronic wounds. Enzymatic debridement appears to be most useful in the removal of eschar when surgical techniques cannot be utilized. The purpose of this study is to determine the efficacy of papain–urea chlorophyllin compared to moist wound care using an infected, acute, porcine full thickness wound model. Twenty full thickness wounds were created on the dorsum of domestic pigs. Following hemostasis, the wounds were contaminated with wound-isolated bacteria then treated with test articles and dressed with moisture-retentive dressing. All the wounds were evaluated 1, 4, 8, 11, 14,18, and 21 days postsurgery for epithelialization and biopsies were obtained for microscopic evaluation. The results showed no adverse effect in reepithelialization in acute wounds when using papain–urea chlorophyllin ointment compared to moist wound care, TEWL measurements also showed no adverse affects from the treatment. Microscopic examination reveals an increase in the number of keratinocytes present in the epidermis of the treated pigs as well as an increase in the depth of rete pegs. New blood vessel formation was increased at all examined time points in the papain–urea chlorophyllin treated pigs, which was verified with CD31 and von Willebrand Factor staining. VEGF was increased after 1 week in the wound fluid from treated wounds compared to moist control. While the reepithelialization rate does not appear to be inhibited by papain–urea-chlorophyllin combination in acute wounds, the healing appears to be more complete based on the number of keratinocytes present in the epidermis and the extensive rete peg formation. The wounds also appear to have enhanced vascularization which is vital in supplying nutrients to the newly healed wound.
Published Version
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