Use of urea to stimulate healing in chronic purulent wounds

Abstract

Urea has been found to stimulate healing in chronic purulent wounds. The effects obtained are a cleansing of the wound by the removal of necrotic material and pyogenic bacteria present, and a promotion of the growth of granulation tissue. Like allantoin, urea occurs in maggot excretions and its presence serves as a further elucidation of the remarkable efficiency of surgical maggots in healing chronic suppurating wounds. This healing action of urea probably accounts in part for the custom prevalent for centuries in Europe, Asia, and Africa, and also practiced in America, of using urine to promote cleansing and healing of wounds. Urea, which is manufactured in enormous quantities for use as a soil fertilizer, is available for therapeutic use without any connection with animal excretions. It can be made from three simple gases, nitrogen, hydrogen and carbon dioxide, and is a pure white crystalline substance. In wound treatment a 2 per cent solution in water has been used on saturated gauze dressings applied directly to the wound. The solution is bland, odorless and nontoxic. The treatment is very inexpensive and easily given. Urea is present in the cells of all the tissues of the body; it rapidly permeates the membranes of the cells and its concentration therein rises and falls readily with that of the blood and lymph. In view of the remarkable cleansing and healing properties of urea in chronic purulent wounds, it appears that the general conception of this material as only a waste product has tended to obscure its therapeutic character.