Abstract
Bioshell calcium oxide (BiSCaO) possesses deodorizing properties and broad microbicidal activity. This study aimed to investigate the application of BiSCaO ointment for the prevention and treatment of infection in chronic wounds in healing-impaired patients, without delaying wound healing. The bactericidal activities of 0.04, 0.2, 1, and 5 wt% BiSCaO ointment, 3 wt% povidone iodine ointment, and control (ointment only) were compared to evaluate the in vivo disinfection and healing of Pseudomonas aeruginosa-infected wounds in hairless rats. Treatment of the infected wounds with 0.2 wt% BiSCaO ointment daily for 3 days significantly enhanced wound healing and reduced the in vivo bacterial counts compared with povidone iodine ointment and control (no wound cleaning). Although 5 wt% BiSCaO ointment provided the lowest bacterial counts during 3 days’ treatment, it delayed wound healing. Histological examinations showed significantly advanced granulation tissue and capillary formation in wounds treated with 0.2 wt% BiSCaO ointment for 3 days compared to wounds treated with the other ointments. This study suggested that using 0.2 wt% BiSCaO ointment as a disinfectant for infected wounds and limiting disinfection to 3 days may be sufficient to avoid the negative effects of BiSCaO on wound repair.
Highlights
Wound healing is the result of a series of correlated cellular processes that are initiated by cytokines and growth factors [1]
We previously showed that treating P. aeruginosa-infected wounds on hairless rats with Bioshell calcium oxide (BiSCaO) suspension (0.2 wt%, pH 12.3) once daily for 3 days and covering the wound with CNFS significantly decreased the P. aeruginosa bioburden and enhanced wound repair [32]
The in vitro bactericidal activities of different concentrations of BiSCaO ointments and 3 wt% povidone iodine ointments against P. aeruginosa were tested by counting the viable bacterial colonies after treatment
Summary
Wound healing is the result of a series of correlated cellular processes that are initiated by cytokines and growth factors [1] These cellular processes are suppressed by tissue bacterial bioburden [2], which may contribute to degradation of the cytokines and growth factors [3]. Several studies have shown that the level of bacterial bioburden can exceed 1 × 106 per gram of tissue [4]. Such high levels of tissue bacteria can be present without clinical signs of infection and can unfavorably affect wound healing [5]. The topical use of antibiotics used systemically for purposes other than wound infection is discouraged because of an increased risk for allergies and the potential for drug resistance [7]
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