Abstract
Venous leg ulcers represent a significant public health problem that will increase as the population ages. Numerous herbs and their extracts are potentially conducive to wound healing, including the ability to serve as antimicrobial, antifungal, astringent etc. The aim of the study was to establish the in-vivo antimicrobial effects of herbal hydrogel formulation DermaplantG. The major components of the DermaplantG were the extracts of Allii bulbus, Hyperici herba and extract of Calendulae flos. A total of 12 patients with non-infected venous leg ulcers were treated twice daily, for 5 weeks, with new hydrogel formulation. All ulcers showed clinical signs of contamination or colonization without signs of systemic infection. Premoistening the swab with sterile saline was considered when the surface of the wound was dry. The tip of the swab was rolled on its side in a zigzag pattern for at least one full rotation. Standard methods for isolation and identification of aerobic and anaerobic bacteria were used. On baseline assessment, a large number of different types of bacteria were detected in all venous leg ulcers. S. aureus and P. aeruginosa were isolated from almost all controls. On baseline, mixed bacterial flora (50%) was isolated in six venous leg ulcers (five ulcers with S. aureus-P. aeruginosa and one ulcer with E.coli-Enterobacter sppP.aeruginosa). At the end of the treatment in DermaplantG group in 8 venous ulcers were detected S. aureus (66.66%) and P. aeruginosa (16.66%), and one venous leg ulcers was detected as sterile (8.33%). The number of different types of isolated bacterial species decreased significantly (P<0.05) after the use of DermaplantG herbal preparations. Therapy in DermaplantG group was administered without any side effects. The preliminary results of this pilot study demonstrate potential antimicrobial effects of herbal therapy on non-infected venous leg ulcers. Acta Medica Medianae 2011;
Highlights
Venous ulcers are common chronic disease requiring continuous therapeutic surveillance, significantly influencing the quality of life [1,2]
A wide variety of agents are available for treatment of venous leg ulcers, including ointments and dressings [3]
This study presents as support of abilities on DermaplantG herbal treatment of venous leg ulcers and their antimicrobiological effects in clinical practice because there is no enough clinical investigations in this area
Summary
Venous ulcers are common chronic disease requiring continuous therapeutic surveillance, significantly influencing the quality of life [1,2]. The microbiological profile of chronic ulcers of the lower limbs has application to general principles of treatment as well as institution-specific guidelines for management [4,5]. Numerous scientific debates suggest the importance of bacterial colonization and its role in ulcer infections and their treatment. The role of bacteria in the pathogenesis of chronic venous ulcers is still unresolved. Infections of the skin, soft tissues and ulcers are most commonly induced by gram-positive bacteria Staphylococcus aureus and Streptococcus pyogenes [1,2]. Within ulcer microflora there are other numerous aerobic, anaerobic and mixed bacteria: Streptococcus faecalis, Pseudomonas aeruginosa, enterococcus faecalis, Enterobacter cloacae, Peptococcus magnus, Escherichia coli, Streptococci group D, Peptostreptococcus spp., Bacteroides fragilis and others [2,4,6]. Clinical signs of infections are related to the type and amount of ulcer microflora. After the administered treatment and a period of time, alterations of type and number of bacteria in all their relationships are possible
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