Povidone Iodine Ointment Research Articles

Effect of Moringa oleifera Lam. on normal and dexamethasone suppressed wound healing

ObjectiveTo investigate aqueous extract of bark of Moringa oleifera for normal wound healing and dexamethasone suppressed wound healing using incision, excision and dead space wound models in Wistar rats. MethodsIn incision and dead space the extracts were applied daily topically till the 10th post wounding days while in excision model it was till the complete epithelialization process. Standard group were treated with Povidone iodine ointment topically daily. The breaking strength, percentage of wound contraction, period of epithelialization, dry granulation weight and hydroxyproline content were observed. ResultsThe aqueous extract of Moringa oleifera significantly increased the wound breaking strength in incision wound model. The aqueous extract treated wounds were found to epithelize faster and the rate of wound contraction was significantly increased as compared to control wounds. Significant increase in granulation breaking strength and hydroxyproline content in dead space wound was observed. The aqueous extract significantly decreased the antihealing activities of dexamethasone in all the wound models. ConclusionsThe results indicated that the aqueous extract of Moringa oleifera promotes wound healing significantly and able to overcome the wound healing suppressing action of dexamethasone.

Antioxidant and wound healing potential of Pistia stratiotes L.

ObjectiveTo investigate the effects of Pistia stratiotes on wound healing activity in Swiss albino mice by excision wound healing model and its antioxidant study was performed to understand the mechanism of wound healing potency. MethodsMice were topically treated with extract formulated in ointment by using simple ointment vaseline as base. 5% and 10% (w/w) ointment was applied once daily. A standard group was treated with Povidone iodine ointment topically. The area of wound was measured on 4, 6, 8, 10, 12, 14, 16 post-wounding days. The scar area on complete epithelization was measured. The parameters observed were wound contraction (mm2), epithelization period and tensile strength including histopathological studies. Antioxidant activity was determined by in vitro method-H2O2 radical scavenging. ResultsTreatment of wound with ointment containing 5% and 10% (w/w) extract of Pistia stratiotes exhibited significant (P < 0.001) wound healing activity when compared with control group. All parameters such as wound contraction (mm2), epithelization period and tensile strength and histopathological studies showed significant changes when compared to control. Extracts possess significant antioxidant activity compared to control group. Ascorbic acid was used as reference standard for antioxidant activity (P<0.001 vs Ascorbic acid). ConclusionThe results conclude that Pistia stratiotes has antioxidant properties, which may be responsible and favorable for faster wound healing and this plant extract may be useful in the management of wounds, it also supports its traditional use.

Healing promoting potentials of roots of Ficus benghalensis L. in albino rats

To screen the wound healing activity of aqueous and ethanolic extract of roots of Ficus benghalensis. Both the extracts were evaluated for wound healing by three modelsie. incision, excision and dead space wound. In incision and dead space the extracts were applied daily topically till the 10 th post wounding days while in excision model it was till the complete epithelialization process. Standard group were administered Povidone iodine ointment topically daily. The breaking strength, percentage of wound contraction, period of epithelialization, dry granulation weight and hydroxyproline content were observed. The result of the present study showed that both extracts were able to increase the breaking strength (incision model), decrease period of epithelialization, increase percentage wound contraction (excision model), increase hydroxyproline content (Dead space wound model) significantly compared with control group (P<0.05). Based on result we conclude that aqueous extract is more effective than ethanolic extract. However, it is needed more research to be carried out especially on toxicity studies of ethanolic extract.

Wound healing activity of Ipomoea batatas tubers (sweet potato)

Background: Ipomoea batatas (L.) Lam. from the family Convolvulaceae is the world’s sixth largest food crop. The tubers of Ipomoea batatas commonly known as sweet potato are consumed as a vegetable globally. The tubers contain high levels of polyphenols such as anthocyanins and phenolic acids and vitamins A, B and C, which impart a potent antioxidant activity that can translate well to show wound healing effects. To check their effects on wound healing, the peels and peel bandage were tested on various injury models in rats in the present study.Methods: The methanolic extracts of the peels and peel bandage of Ipomoea batatas tubers (sweet potato) were screened for wound healing by excision and incision wound models on Wistar rats. Three types of gel formulations were prepared, viz., gel containing 3.0% (w/w) peel extract, gel containing 6.0% (w/w) peel extract and gel containing 10% (w/w) peel extract. Betadine (5% w/w povidone iodine cream) was used as a reference standard. In the incision wound model, Tensile strength of the skin was measured. Epithelization time, wound contraction, hydroxyproline content of the scab, and ascorbic acid and malondialdehyde content of the plasma were determined in the excision wound model.Results: In the incision wound model, high tensile strength of the wounded skin was observed in animals treated with the peel extract gels and the peel bandage when compared with wounded control animals. The increase in tensile strength indicates the promotion of collagen fibers and that the disrupted wound surfaces are being firmly knit by collagen. In the excision wound model, significant wound closure was observed on the 4th day in rats treated with all three gel formulations when compared with the wounded control rats. A significant increase in hydroxyproline and ascorbic acid content in the gel-treated animals and a significant decrease in malondialdehyde content in the animals treated with gel as well as peel bandage was observed when compared with the wounded control animals.Conclusion: It may be concluded that the peels of Ipomoea batatas tubers possess a potent wound healing activity, which may be due to an underlying antioxidant mechanism.Key Words: Sweet potato peels, excision wound, incision wound, wound healing

Preliminary pharmacological evaluation of Martynia annua Linn leaves for wound healing

Objective To evaluate the wound healing potential of fractions from ethanol extract of Martynia annua ( M. annua) Linn leaves. Methods Ethanol extract of M. annua Linn leaves was fractionate into three different fractions (MAF-A, MAF-B and MAF-C) which were screened for wound healing potential using two models: excision and incision on rats. The thin layer chromatography (TLC) profile of all fractions were analyzed and TLC of luteolin was also done. The Povidone-Iodine Ointment was used as reference for comparision. Excision and incision wounds were created on dorsal portion of rats for study. Wound contraction, biochemical parameters (protein level and hydroxyproline level) and histopathological study were performed in excision wound model whereas incision model was used for determination of tensile strength. Results The wound contraction and tensile strength of skin tissues were observed significantly greater in MAF-C fraction treated group than other two fractions ( P < 0.01). In excision wound method (on day 18) protein content and hydroxyproline were found significantly higher in MAF-C group than control group ( P < 0.01). Histopathological study also showed better angiogenesis, matured collagen fibres and fibroblast cells as compared with the control group. Conclusions In conclusion, our findings suggest that fraction MAF-C from ethanol extract of M. annua leaves is found most effective in wound healing.

Effect of povidone iodine cream for external application to the chemotherapy extravasation injury

Objective To observe the effect of povidone-iodine cream to treat and prevent from the chemotherapy extravasation injury. Methods 224 cases with chemotherapy drugs treatment were divided into treatment group and control group. The treatment group was treated with povidone-iodine gauze topical cream,the control group was treated with the conventional methods such as partial closure of 2% procaine, ice application and hirudoid externally application, 50% magnesium sulfate wet covering and so on. Ridit analysis has been applied to compare the clinical efficacy of different group. Results The total effective rate was 92.9% in the treatment group, while the total efficiency rate of 77.6% in the control group. The effective rate was significantly different between the two groups (χ2 = 11.518, P ＜ 0. 05). Conclusions Povidone-iodine cream has better effectiveness to control the chemotherapy extravasation injury compared with the conventional methods. Key words: Chemotherapy medicine; Extravasation injury; Povidone-iodine cream

Assessment of Biological Activities: A Comparison of Pergularia daemia and Jatropha curcas Leaf Extracts

The present study was aimed to compare the wound healing, free radical scavenging and cytotoxicity potentials of Jatropha curcas and Pergularia daemia leaf extracts. Quantitative analysis for some phytochemicals; flavonoids, phenols, glycosides, tannins, saponins and alkaloids were carried out using standard methods. Herbal ointments containing 50% (w/w) methanol leaf extracts of Jatropha curcas and Pergularia daemia were formulated. Excision wound measuring 7x7 mm 2 was created and the ointment applied topically on the wounded area which was measured at intervals of 4 days. Blank ointment (paraffin base) served as the negative control while Povidone iodine ointment served as the standard treatment. On the 16 th day, rats treated with the standard drug (Povidone iodine) showed 82.1% wound closure; J. curcas -treated rats showed 91.3% wound healing while P. daemia treated rats exhibited 97.2% wound closure, indicating an efficacy of the formulations. The ointment formulated with P. daemia leaf extract had the best wound healing potential with very minimal scar formulation. The phytochemical screening revealed that the leaves of J. curcas and P. daemia contain tannins, alkaloids, phenols, flavonoids and glycosides. J. curcas had appreciable amount of saponins, however, saponins were not detected in P. daemia. The LC50 values for J. curcas and P. daemia were 586.79 µg/ml and 344.26 µg/ml, respectively while that of the standard (Potassium dichromate) was 62.52 µg/ml. The crude methanol extracts of J. curcas and P. daemia possessed free radical scavenging activities with IC50 of 90.83 and 214.16 µg/ml, respectively while that of the standard quercetin was 50.71 µg/ml. The results obtained in this study strongly support the verbal claims on the use of these plants for wound healing. It also indicates that J. curcas and P. daemia are potential sources of natural antioxidants and are relatively safe for the purposes utilized. Research Article

Interventions for preventing infectious complications in haemodialysis patients with central venous catheters

Central venous catheters (CVC) continue to play a prominent role in haemodialysis vascular access with 46% to 70% of patients commencing haemodialysis via a CVC. CVC access is associated with catheter-related infections, increased patient hospitalisations and death due to infection. A variety of interventions are used to prevent CVC infection. To evaluate the benefits and harms of prophylactic topical antimicrobials, topical antiseptics, medicated and non-medicated dressings on infectious complications among haemodialysis patients with CVC. We searched the Cochrane Renal Group's specialised register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and reference lists of articles without language restriction. We included randomised controlled trials (RCTs) and quasi-RCTs investigating any intervention that prevented infectious complications among haemodialysis patients with CVC. We excluded antimicrobial impregnated CVC or CVC using locking solutions with antimicrobial properties. Two authors assessed study quality and extracted data. Dichotomous outcomes were expressed as risk ratios (RR) with 95% confidence intervals (CI) and continuous outcomes as mean differences (MD). Ten studies (786 patients) were included. Mupirocin ointment reduced the risk of catheter-related bacteraemia (RR 0.17, 95%CI 0.07 to 0.43) and had a significant effect on catheter-related infections caused by S. aureus. The risk of catheter-related bacteraemia was reduced by polysporin (RR 0.40, 95%CI 0.19 to 0.86) and povidone-iodine ointment (RR 0.10, 95%CI 0.01 to 0.72). Subgroup analysis suggested mupirocin (RR 0.12, 95%CI 0.01 to 2.13) and povidone-iodine ointment (RR 0.84, 95%CI 0.24 to 2.98) had no effect on all-cause mortality while polysporin ointment showed a significant reduction (RR 0.22, 95%CI 0.07 to 0.74). Mortality related to infection was not reduced by mupirocin, polysporin or povidone-iodine ointment. Topical honey did not reduce the risk of exit site infection (RR 0.45, 95%CI 0.10 to 2.11) or catheter-related bacteraemia (RR 0.80, 95%CI 0.37 to 1.73). Transparent polyurethane dressing compared to dry gauze dressing did not reduce the risk of CVC or exit site infection, or catheter-related bacteraemia. Mupirocin ointment appears effective in reducing the risk of catheter-related bacteraemia. Insufficient reporting on mupirocin resistance was noted and needs to be considered in future studies. A lack of high quality data on the routine use of povidone-iodine ointment, polysporin ointment and topical honey warrant larger RCTs. Insufficient data were available to determine which dressing type (transparent polyurethane or dry gauze dressing) has the lowest risk of catheter-related infections.

Long-term results of anterior sagittal anorectoplasty for the treatment of vestibular fistula

Purpose Vestibular fistula is the commonest anorectal malformation in the female child. This article reports the treatment and long-term follow-up of 1206 patients of vestibular fistula treated by anterior sagittal anorectoplasty (ASARP) in a single center for 38 years. Material and Methods All patients of vestibular fistula admitted and operated on at the Department of Pediatric Surgery, King George Medical University (Lucknow, UP India), from 1970 were included in the study; the age ranged from 2 days to 40 years. The diagnosis was made by clinical examination. We differentiated between anovestibular fistula (AVF) and rectovestibular fistula (RVF) in that the latter is a longer narrow fistula closely applied to the posterior wall of the vagina. Preoperative investigations included hemogram and blood glucose. Echocardiography was done in those patients showing a physical sign of cardiac anomaly. All patients were operated on in the lithotomy position by ASARP; this was done without colostomy in 1169 patients. In 6 patients, preliminary colostomy was done because of excessive perineal excoriation, and 31 others had colostomy done elsewhere. The striated muscle complex was delineated by electrostimulation, and anoplasty was performed after anchoring the rectum within the muscle complex. Washing of the perineum after passage of stools with application of povidone-iodine ointment constituted the local care. Intravenous antibiotics were administered for 48 hours and oral antibiotics (including metronidazole) for 5 days. The patient was discharged home by the fifth day. Results Follow-up ranges from 3 months to 19 years; uneventful postoperative recovery was seen in 1147 patients. They had normal growth and development, normal appearance of the perineum, and a normal quality of life. Complications were seen in 60 patients (5%) of which 42 had AVF and 18 had RVF. Eight patients had postoperative wound disruption that was minor in 4 and required colostomy in the other 4. Four patients had recurrence of vestibular fistula thus creating an iatrogenic perineal canal; this could be repaired by a second ASARP in 3 patients and required colostomy and PSARP in one child. Anal stenosis was seen in 11 patients; this was treated by dilatation alone in 6 and required posterior Y-V plasty in 5. The rate of complications in RVF was lower than AVF probably because of lesser number of patients; there was no difference in stooling pattern or continence between uncomplicated patient of RVF and AVF; however, fecal staining was seen in all patients undergoing revision surgery for complications. Conclusions This experience with ASARP showed a good result in 95% patients in a single-stage procedure. The technical ease and minimal preoperative and postoperative measures make ASARP the procedure of choice for vestibular fistula in females at all ages. Until sufficient experience is gained, it may be safer to operate on patients with RVF under cover of a protective colostomy.

Wound healing activity of Calotropis gigantea root bark in rats

Ethnopharmacological relevance Calotropis gigantea R.Br. (Asclepiadaceae) is a perennial undershrub found chiefly in wastelands throughout India. It has been reported as a traditional folkloric medicine for a variety of alignments. The plant Calotropis gigantea is also used in some parts of India for wound healing in combination with other plants. However there are no scientific reports on wound healing activity of the plant Calotropis gigantea R.Br. Aim of the study To investigate the effects of Calotropis gigantea root bark on wound healing activity in rats by excision, incision and dead space wound healing models in rats. Methodology Wistar albino rats of either sex weighing between 180 and 200 g were topically treated with extract formulated in ointment by using simple ointment BP as base. 5% (w/w) ointment was applied once daily in excision wound model. Calotropis gigantea ethanolic extract was given orally at a dose of 100, 200, and 400 mg/kg in incision and dead space wound healing models. Rats of standard groups were treated with 5% Povidone iodine ointment topically. The percentage wound closure, epithelization time, hydroxyproline content and scar area on complete epithelization were measured. Results Topical application of Calotropis gigantea in excision wound model increased the percentage of wound contraction. Scar area and epithelization time were decreased. In incision wound and dead space wound breaking strength of wounds and hydroxyproline was increased. Conclusion Calotropis gigantea accelerated wound healing in rats and thus supports its traditional use.

A poly‐herbal formulation accelerates normal and impaired diabetic wound healing

In the present study, a poly-herbal formulation (PHF) was prepared by combining the aqueous lyophilized leaf extracts of Hippophae rhamnoides L. and Aloe vera L. and the ethanol rhizome extract of Curcuma longa L., in an optimized ratio (1 : 7 : 1). The efficacy of PHF treatment was studied in normal and impaired diabetic rats using a full-thickness cutaneous wound model. Topical PHF treatment increased cellular proliferation and collagen synthesis at the wound site in normal rats, as evidenced by the significant increase in DNA, total protein, hydroxyproline, and hexosamine contents in comparison with a positive control treated with a povidone-iodine ointment. The histological examinations and matrix metalloproteinases expression also correlated well with the biochemical findings, confirming the efficacy of PHF in normal wounds. In the streptozotocin-induced diabetic rats, PHF treatment increased hydroxyproline and hexosamine content. A faster wound contraction was also observed in PHF-treated normal and diabetic rats. The PHF also promoted angiogenesis as evidenced by an in vitro chick chorioallantoic membrane model and in vivo up-regulated vascular endothelial growth factor expression. The results suggest that PHF possesses significant wound healing potential in both normal as well as chronic diabetic wounds.

Traditional smallpox vaccination with reduced risk of inadvertent contact spread by administration of povidone iodine ointment

One concern with traditional smallpox vaccination is inadvertent spread of virus to atopic or immunocompromised contacts. To reduce this risk, we tested the ability of povidone iodine to inactivate infectious virus at the vaccination site beginning at 7 days after transcutaneous smallpox vaccination. This ointment rapidly inactivated virus on the skin without reducing neutralizing antibody titers or antiviral T cell responses. Moreover, there was no delay in healing/eschar separation following povidone iodine application. Together, this indicates that administration of an antiviral/antimicrobial cream can effectively block virus shedding after traditional smallpox vaccination and reduce the risks of autoinoculation or contact spread.

Effects of Rhodiola imbricata on Dermal Wound Healing

Rhodiola imbricata (Crassulaceae) is a perennial herb growing at high-altitude (4000 - 5000 m) in the western Himalayas. The present study was aimed at investigating the healing efficacy of R. imbricata rhizome ethanol extract using a rat excision wound model. The extract was found to be rich in polyphenols. The extract treated wounds were found to heal much faster as indicated by the improved rate of wound contraction and decreased time taken for epithelialization (11.33 vs. 18.33 days in the untreated group). The extract treatment increased cellular proliferation and collagen synthesis at the wound site, as evidenced by the increases in DNA, protein, hydroxyproline and hexosamine contents in comparison to a positive control treated with povidone-iodine ointment. These results were also supported by histological examinations. Furthermore, the treatment also caused an increase in antioxidant and a decrease in lipid peroxide levels in the granulation tissue. The results suggest that R. imbricata rhizome ethanol extract possesses a significant wound healing activity.

Povidone-iodine ointment: No delay of split skin graft healing

Povidone-iodine ointment: No delay of split skin graft healing

Health Care Workers' Nasal Carriage and Outbreak Control of Epidemic Methicillin Resistant Staphylococcus aureus

BACKGROUND/OBJECTIVES: Methicillin resistant Staphylococcus aureus(MRSA) is the major pathogen of nosocomial infections. There are many reports that MRSA nasal carriers play a major role in transmitting MRSA. We studied to estimate the nasal carriage rates, therapeutic effects of nasal carriers and control of MRSA outbreaks in a tertiary, acute and educational hospital. METHODS: From 1990 to 1997, eight MRSA epidemics were detected and investigated for outbreak control. We surveyed the MRSA colonization of anterior nares and hands of health care workers (HCW). MRSA was identified by staphylococcal broth, mannitol-salt-agar, Muller-Hinton-oxacillin agar. To identify the persistent carriers in the HCWs, the nasal swabs were done weekly for 3weeks. Two percent povidone iodine ointment or 2% mupirocin ointment was applied topically to treat the persistent MRSA nasal carriers. RESULTS: Of eight MRSA outbreaks, five epidemics occurred in the intensive care unit, all of them occurred in surgical departments and five of them occurred in winter seasons. For eight MRSA outbreaks, 351 HCWs were surveyed. The rates of transient carriers was 10.8% (38/351) and the rates of that were 9.0% (10/111) in medical doctors (MD), 12.5% (24/192) in registered nurses (RN) and 11.4% (4/35) in aid nurses (p = 0.470). The rate of persistent carrier in doctors was 1.8%, and that in RNs was 3.7% (p = 0.490). After topical therapy with 2% povidone iodine ointment or 2% mupirocin ointment for persistent carriers, MRSA was not identified for 2months follow up. CONCLUSIONS: In MRSA epidemics, the rate of the transient carrier rate of MRSA in HCWs was 10.8% and the rate of the persistent carrier was 2.6%. The difference of carrier rates in HCWs was not significant statistically. The therapy for the persistent nasal carriers in HCWs with two percent povidone iodine ointment or 2% mupirocin ointment was very effective. And MRSA outbreaks were ended and controlled for 6months follow up. BACKGROUND/OBJECTIVES: Methicillin resistant Staphylococcus aureus(MRSA) is the major pathogen of nosocomial infections. There are many reports that MRSA nasal carriers play a major role in transmitting MRSA. We studied to estimate the nasal carriage rates, therapeutic effects of nasal carriers and control of MRSA outbreaks in a tertiary, acute and educational hospital. METHODS: From 1990 to 1997, eight MRSA epidemics were detected and investigated for outbreak control. We surveyed the MRSA colonization of anterior nares and hands of health care workers (HCW). MRSA was identified by staphylococcal broth, mannitol-salt-agar, Muller-Hinton-oxacillin agar. To identify the persistent carriers in the HCWs, the nasal swabs were done weekly for 3weeks. Two percent povidone iodine ointment or 2% mupirocin ointment was applied topically to treat the persistent MRSA nasal carriers. RESULTS: Of eight MRSA outbreaks, five epidemics occurred in the intensive care unit, all of them occurred in surgical departments and five of them occurred in winter seasons. For eight MRSA outbreaks, 351 HCWs were surveyed. The rates of transient carriers was 10.8% (38/351) and the rates of that were 9.0% (10/111) in medical doctors (MD), 12.5% (24/192) in registered nurses (RN) and 11.4% (4/35) in aid nurses (p = 0.470). The rate of persistent carrier in doctors was 1.8%, and that in RNs was 3.7% (p = 0.490). After topical therapy with 2% povidone iodine ointment or 2% mupirocin ointment for persistent carriers, MRSA was not identified for 2months follow up. CONCLUSIONS: In MRSA epidemics, the rate of the transient carrier rate of MRSA in HCWs was 10.8% and the rate of the persistent carrier was 2.6%. The difference of carrier rates in HCWs was not significant statistically. The therapy for the persistent nasal carriers in HCWs with two percent povidone iodine ointment or 2% mupirocin ointment was very effective. And MRSA outbreaks were ended and controlled for 6months follow up.

Conservative management of necrotizing fascitis in children

Background Necrotizing fascitis (NF) is a severe infection of the subcutaneous tissue and fascia affecting children and adults. Conventional management includes resuscitation, aggressive debridement of necrotic tissue, and sometimes, additional measures such as hyperbaric oxygen and immunoglobulin therapy. This paper reports conservative management of 18 patients with NF with minimal morbidity and mortality. Material and Methods Patients with NF admitted to our department between January 2000 and February 2004 were included in the study (N = 18). In all cases, the presentation was rapidly progressing cellulitis progressing to cutaneous gangrene between 6 and 18 hours. The patients were managed by aggressive fluid resuscitation, analgesia, broad-spectrum antibiotics, and dressing with liberal quantities of povidone iodine ointment. After separation of the gangrenous skin margins from the surrounding healthy tissue between 24 and 72 hours, dead skin and fascia were removed with forceps on the ward, the wound washed with liberal quantities of water, and the ointment dressing reapplied. This procedure was repeated until all the dead tissue had been removed. Once the wound was granulating, dressings were changed at increasing intervals until healing took place by secondary intention. Results The patients were aged between 5 days and 11 years. In all, NF began as a small boil progressing to a rapidly spreading cellulitis. None of the patients was operated during the acute stage of the infection. Blackening of the skin and separation of the edges occurred within 8-72 hours, the dead tissue was allowed to separate from the granulating base and could be removed at the bedside with minimal blood loss. Blood transfusion was required only in 2 patients where hemoglobin was < 9 gm/dL. Of the 18 patients, 6 grew group A streptococci and staphylococci in a polymicrobial wound culture, whereas the other 12 had polymicrobial flora without streptococci. The clinical course and outcomes were similar in both types of wounds. There was 1 death in the study group, and 1 patient required skin grafting. All other survivors had healing by secondary intention without disability. The period for complete epithelization varied between 3 and 8 weeks. Patients were discharged home when 70% of the wound had healed. There was extensive scarring in 3 children with NF involving the back. The other children had minimal or no scarring. None of the patients had any restriction in the movement of limbs or joints. These findings were compared with 16 retrospective patients of NF treated before January 2000 by the conventional approach of aggressive early debridement, the results of the conservative approach were superior with shorter hospital stay, lower number of blood transfusions, earlier appearance of granulation tissue, and shorter duration of complete healing. Conclusions We conclude that the conservative management of NF offers advantages in morbidity without compromising the outcome. In our hospital setup, conservative treatment was less expensive and easily carried out. We would therefore advocate conservative management for the treatment of this condition.

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CHAPTER 4

Our Method of Povidone-Iodine Ointment and Gauze Dressings Reduced Catheter-Related Infection in Serious Cases

In experiment 1, we evaluated our method of catheter care at subclavian vein insertion sites for the control of catheter-related infections in seriously ill neurosurgical patients who needed prolonged catheter placement, compared with an older method. In our method, the insertion site was prepared with 10% povidone-iodine solution, followed by application of 10% povidone-iodine ointment, and covered with sterile gauze and a transparent polyurethane dressing. The older method was based on 1996 guidelines for the prevention of intravascular device-related infections. Catheter colonization and mortality were both found to be significantly reduced with our method (p = 0.0214, p = 0.0379, respectively). In experiment 2, we evaluated whether a regimen of catheter care with 10% povidone-iodine ointment was more effective than that without povidone-iodine ointment for the prevention of infections. This suggested effectiveness of 10% povidone-iodine ointment for reduction of infection. Our method of catheter care was useful even in seriously ill neurosurgical patients.

Wound-Healing Property ofMomordica charantiaL. Fruit Powder

Momordica charantia Linn. fruit powder, in the form of an ointment (10% w/w dried powder in simple ointment base), was evaluated for wound-healing potential in an excision, incision and dead space wound model in rats. The rats were divided into three groups of control, treatment and reference in all three wound models, each group consisting of six rats. Wound-contraction ability in excision wound mode was measured at different time intervals on days 4, 8, 10, 12 and 14 , and the study was continued until the wound had completely healed. Tensile strength was measured in 10-day-old incision and granuloma wound. Histological studies were performed on 10-day-old sections of regenerated tissue. Powder ointment showed a statistically significant response (P < 0.01), in terms of wound-contracting ability, wound closure time, period of epithelization, tensile strength of the wound and regeneration of tissues at wound site when compared with the control group, and these results were comparable to those of a reference drug povidone iodine ointment.

A Preclinical Study of the Effects of Seabuckthorn (Hippophae rhamnoides L.) Leaf Extract on Cutaneous Wound Healing in Albino Rats

Hippophae rhamnoides L. (family Elaeagnaceae), commonly known as seabuckthorn, is a wild shrub growing at high altitude (1200-4500 meters) in adverse climatic conditions. The aim of the present study was to evaluate healing potential of seabuckthorn leaves in a preclinical study on rats using a cutaneous excision-punch wound model. Four full-thickness excision-type wounds of 8.0 mm diameter were created on the dorsal surface of rats under aseptic conditions. The aqueous lyophilized extract of seabuckthorn leaves, at doses of 0.5%, 1.0%, and 1.5% w/v prepared in propylene glycol, were applied topically twice daily for 7 days. Control animals received the vehicle alone in an identical manner. Wound granulation tissues were excised on eighth day postwounding, and the hydroxyproline, hexosamine, total protein content, and antioxidant levels were determined. Wound surface area was also measured on the eighth day before wound excision to determine wound contraction. Topical application of 1.0% seabuckthorn leaf extract statistically significantly augmented the healing process, as evidenced by increases in the content of hydroxyproline and protein as well as the reduction in wound area when compared with similar effects in response to treatment using povidone-iodine ointment (standard care). The reduced glutathione, vitamin C, superoxide dismutase, catalase, and glutathione peroxidase activities showed significant increases in seabuckthorn leaf extract-treated wounds as compared to controls. The lipid peroxide levels were significantly decreased in leaf extract-treated wounds. The results suggest that aqueous leaf extract of seabuckthorn promotes wound healing, which may be due to increased antioxidant levels in the granulation tissue.