Silver Sulfadiazine Treatment Research Articles

In vivo and in silico studies of the effects of oil extracted from Cannabis sativa L. seeds on healing of burned skin wounds in rats.

This study investigates the potential effects of cannabis seed oil (CSO) on the wound healing process. The aim was to assess the efficacy of CSO in treating skin wounds using an animal model and to explore its anti-inflammatory properties through in silico analysis. Eighteen male albino Wistar rats, weighing between 200 and 250g, were divided into three groups: an untreated negative control group, a group treated with the reference drug silver sulfadiazine (SSD) (0.01g/mL), and a group treated topically with CSO (0.962g/mL). The initial wound diameter for all groups was 1 cm. In silico studies were conducted using Maestro 11.5 to evaluate the anti-inflammatory effects of phytoconstituents against cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). CSO and SSD treatments led to a significant reduction (p <0.05) in the size of burned skin wounds by day 5, with contraction rates of 53.95% and 45.94%, respectively, compared to the untreated negative control group. By day 15, wounds treated with CSO and SSD had nearly healed, showing contraction rates of 98.8% and 98.15%, respectively. By day 20, the wounds treated with CSO had fully healed (100%), while those treated with SSD had almost completely healed, with a contraction rate of 98.97%. Histological examination revealed granulated tissue, neo-blood vessels, fibroblasts, and collagen fibers in wounds treated with CSO. In silico studies identified arachidic acid, γ-linolenic acid, and linolenic acid as potent inhibitors of COX-1 and COX-2. Serum biochemical parameters indicated no significant changes (p > 0.05) in liver and kidney function in rats treated with CSO, whereas a significant increase (p < 0.01) in ALAT level was observed in rats treated with SSD. The findings demonstrate that CSO has a promising effect on wound healing. The CSO treatment resulted in significant wound contraction and histological improvements, with no adverse effects on liver and kidney function.However, the study's limitations, including the small sample size and the need for detailed elucidation of CSO's mechanism of action, suggest that further research is necessary. Future studies should focus on exploring the molecular pathways and signaling processes involved in CSO's pharmacological effects.

In vitro analysis of interactions between Pseudomonas aeruginosa and Candida albicans treated with silver sulfadiazine in wound infections.

Microorganisms tend to rely on close relationships with other species to survive. Consequently, biofilms formed by interactions of different species have been shown to delay the wound healing process. Studies suggest these mixed-population infections contribute to the development of drug resistance and inhibition of host immune response. Silver sulfadiazine (SSD) has been shown to effectively decrease the risk of infection in an open wound. Typically, these are bacterial wound infections; however, the role of fungal species needs further attention. The purpose of this in vitro study was to determine the effect of SSD on interactions between Pseudomonas aeruginosa 09-009 (PA1) or P. aeruginosa 09-010 (PA2) and Candida albicans ATTC 64550 (CA). A mixture of 4 mL of tryptic soy broth (TSB) and 100 µL of CA and/or PA1 or PA2 (∼106 log cfu/mL) inoculums were deposited into either wells or vials. The wells or vials were then sonicated (50 W for 10 s) to separate microorganisms attached to the walls. After incubation, cell counts were performed at 24 and 48 h for each microorganism using specific media. Our results show that without SSD treatment, P. aeruginosa exhibits an inhibitory effect on C. albicans. Treatment with SSD demonstrated significant reduction of P. aeruginosa; however, C. albicans persisted. This experiment demonstrates that SSD was effective in reducing the bioburden of both P. aeruginosa strains after 24 and 48 h; however, it was not as effective in reducing C. albicans. The data suggest that for polymicrobial mixed infections containing Pseudomonas spp. and C. albicans, treatment with SSD may be beneficial but does not provide adequate microorganism eradication. As such, added treatments that provide coverage for Candida infection are necessary. Additional in vivo studies are needed to obtain a better understanding of the complex interactions between these organisms.

Wound Healing and Acute Dermal Toxicity Studies of Ludwigia octovalvis (Jacq.) P. H. Raven (Onagraceae) in Sprague–Dawley Rats

Introduction. The aerial part of Ludwigia octovalvis has been used traditionally in some parts of Asia for the management of wounds owing to the presence of phytochemicals such as tannins, flavonoids, and triterpenoids among others. The incidence of wounds, their associated complications, and the cost of wound care are on the increase globally, therefore, the need to develop alternative wound care agents. The aim of this study was to scientifically investigate the wound healing potential of the ethanolic extract of L. octovalvis using the excision wound healing model in rats and also carry out an acute dermal toxicity investigation of the plant extract. Method. A 70% ethanol extract of L. octovalvis was prepared for the wound healing activity using the excision wound healing model in Sprague–Dawley rats. Aqueous creams (1, 3, and 10%) were prepared and topically applied to the wounds once daily according to the groups of animals. The wounds were assessed for rates of wound closure on days 3, 5, 7, 9, and 11. Re‐epithelialization periods were also determined. Sections of wound tissues obtained on day 13 were subjected to histological investigations. An acute dermal toxicity of the plant extract was investigated. Results. L. octovalvis treatment (1, 3, and 10%) exhibited a mean percentage wound contraction range of 85.36 ± 7.22–94.14 ± 2.23 on day 11. The extract exhibited re‐epithelialization periods of 17.3 ± 1.2, 19.8 ± 2.6, and 16.0 ± 1.7 days for the 1, 3, and 10% extract creams, respectively, whereas the cream‐only and 1% silver sulfadiazine treatments resulted in a re‐epithelialization period of greater than 28 days. Histopathological investigation revealed enhanced fibroblast infiltration and collagen deposition in the treatment groups. No adverse reaction was observed in the acute dermal toxicity study. Conclusions. Extract of L. octovalvis exhibited wound healing by enhancing wound contraction, re‐epithelialization, fibroblast infiltration, and collagen deposition at the wound site. The extract did not exhibit any toxic reaction in the acute dermal toxicity study.

Bioinspired gelatin based sticky hydrogel for diverse surfaces in burn wound care

Proper burn wound management considers patient’s compliance and provides an environment to accelerate wound closure. Sticky hydrogels are conducive to wound management. They can act as a preventive infection patch with controlled drug delivery and diverse surface adherence. A hypothesis-driven investigation explores a bioinspired polydopamine property in a gelatin-based hydrogel (GbH) where polyvinyl alcohol and starch function as hydrogel backbone. The GbH displayed promising physical properties with O–H group rich surface. The GbH was sticky onto dry surfaces (glass, plastic and aluminium) and wet surfaces (pork and chicken). The GbH demonstrated mathematical kinetics for a transdermal formulation, and the in vitro and in vivo toxicity of the GbH on test models confirmed the models’ healthy growth and biocompatibility. The quercetin-loaded GbH showed 45–50% wound contraction on day 4 for second-degree burn wounds in rat models that were equivalent to the silver sulfadiazine treatment group. The estimates for tensile strength, biochemicals, connective tissue markers and NF-κB were restored on day 21 in the GbH treated healed wounds to imitate the normal level of the skin. The bioinspired GbH promotes efficient wound healing of second-degree burn wounds in rat models, indicating its pre-clinical applicability.

Contribution of Topical Agents such as Hyaluronic Acid and Silver Sulfadiazine to Wound Healing and Management of Bacterial Biofilm.

Background and Objectives: Wound healing is commonly associated with critical bacterial colonization or bacterial infection, which induces prolonged inflammation, resulting in delayed re-epithelialization. An appropriate wound dressing requires a humid environment, which also functions as a barrier against bacterial contamination and will accelerate a regenerative response of the wound. Silver sulfadiazine (SSD) is used to prevent wound infection. Hyaluronic acid (HA) is an extracellular matrix component involved in tissue regeneration. This retrospective study was conducted to evaluate the effectiveness of cream and gauze pads based on hyaluronic acid at low molecular weight (200 kDa) and silver sulfadiazine 1% in the wound healing process. In addition, we examined SSD action on biofilms in vitro and on animal wounds, obtaining positive outcomes therefrom. Materials and Methods: We selected 80 patients with complicated chronic wounds of different etiologies, including diabetes mellitus (10), post-traumatic ulcers (45), burns (15), and superficial abrasion (10). Results: After 8 weeks, ulcer size was decreased in 95 ± 2% of the treated patients; a significant reduction in the inflammatory process was observed from day 14 onwards (p < 0.01 vs. baseline), considering improvement of the surrounding skin and reduction of the bacterial load. The SSD treatment decreased bacterial colony proliferation, both in planktonic state and in biofilm, in a dose-dependent manner on the wound but inhibited the development of tissue granulation at the highest dose (800 μg/wound). Conclusions: In conclusion, the combined action of SSD and HA is clinically effective in improving wound healing.

Treatment of experimentally induced partial-thickness burns in rats with different silver-impregnated dressings.

To evaluate the morphometric, macroscopic and microscopic aspects of experimentally induced partial-thickness burns in rats treated with different silver-based dressings. Wistar rats were used, divided into six treatments: saline (NaCl 0.9%); silver sulfadiazine 1%; Silvercel; Mepilex Ag; Aquacel Ag and Acticoat. The animals were monitored daily and euthanized at 7, 14 and 30 days after injury induction (DAI). At 7 DAI, necrosis/crust was greater in control, silver sulfadiazine and Mepilex Ag treatments, granulation tissue was induced by Aquacel Ag, polymorphonuclear infiltrate (PMN) infiltration was intensified by Mepilex Ag; mononuclear infiltrate (MN) infiltration and angiogenesis were increased by Silvercel. At 14 DAI, hemorrhage was decreased by Silvercel and Mepilex Ag, PMN infiltration increased by Acticoat. At 30 DAI, angiogenesis was greater in the Acticoat treatment and fibroblasts were increased by Acticoat and Mepilex Ag. Collagen was induced at 14 DAI by silver sulfadiazine and Aquacel Ag and, at 30 DAI, by silver sulfadiazine and Silvercel treatments. Silvercel and Acticoat presented better results than the other products. However, all the dressings were better than the control at some point during the process, and may contribute to the healing of partial thickness burns. Silvercel and Aquacel Ag treatments induced better cosmetic outcomes regarding wound closure and scarring.

A small-scale re-evaluation of the efficacy of silver sulfadiazine for burns.

Burns remain one of the most common injuries contributing to an increase in trauma incidence in hospitals, particularly in developing countries. Therefore, it is essential to identify the appropriate care for these wounds. Silver sulfadiazine has been widely used for the treatment of burns, but its efficacy has not been re-evaluated in recent years. Therefore, this small-scale study aimed at re-evaluating the use of silver sulfadiazine in patients with burns at a hospital in Magelang, Indonesia. A total of seven patients with second- and third-degree burns were involved and received silver sulfadiazine for 5 months (March to July 2020). Data on their wounds were collected three times and evaluated by using the Nursing Outcomes Classification (NOC) observation method. Wound outcomes were evaluated using on the basis of wound healing by secondary intention. Silver sulfadiazine was found to be effective; 85.7% of the wound area showed granulation tissue, and 75-100% of the wound area showed epithelialisation. However, patients complained of pain during silver sulfadiazine treatment. Therefore, additional nursing interventions seem to be needed to manage burns.

Effect of Multiradiance Low-Level Laser Therapy and Topical Silver Sulfadiazine on Healing Characteristics of Dermal Wounds in Marine Toads (Rhinella marina).

Current recommendations for wound management in amphibians are based primarily on clinical experience and on extrapolation from other taxa, whereas controlled clinical studies are lacking. Low-level laser therapy, also termed photobiomodulation, has gained popularity in veterinary medicine and may represent a valuable adjunct therapy for wound care in amphibians, though dosing and safety evaluations have not been previously reported. Silver sulfadiazine (SSD), a topical antimicrobial, is commonly utilized in amphibian medicine but little is known about its effects on wound healing in this class of animals. This pilot study evaluated the effects of repeated treatments of low-level laser therapy or topical SSD on second-intention healing characteristics of surgically induced full-thickness dermal wounds in 33 adult wild-caught marine toads. Toads were anesthetized, and a 6 mm cutaneous biopsy was performed over the right dorsum. They were then randomly assigned to one of three groups: laser therapy (LT) at 5 Hz (905 nm wavelength on a super pulsed sequence), topical SSD (SD), or control sham treatment (CT). Treatments were administered at 24 hrs after biopsy and then every 72 hrs thereafter, concurrent with a visual assessment of the wound. Toads were euthanized at one of five timepoints (day 4, 7, 13, 19, or 28) to permit scoring of histologic criteria, including lymphocytic inflammation, granulomatous inflammation, heterophilic inflammation, granulation tissue, fibrosis, and reepithelialization. Visual assessments and histologic scoring did not identify a benefit of laser therapy or SSD as compared to controls. Laser therapy and SSD, at the doses and dosing schedule utilized in this pilot study, appear to be safe and well-tolerated treatments in marine toads, but may not be warranted for uncomplicated skin wounds in this species.

Investigation of acute effects of topical Alpinia officinarum (galangal) treatment in experimental contact type burns and comparison with topical silver sulfadiazine treatment.

It was aimed to determine whether Alpinia officinarum (AO) (galangal), which has been regarded to be effective on wound healing, is healing on experimental contact type burns and compare its effects with silver sulfadiazine (SSD). Thirty-five rats were divided into five groups of seven rats each group. Superficial second degree burns were formed by contacting a 1×1 cm copper tip which was kept at 100°C constant temperature to the three shaved areas on the back of rats without applying any pressure for 10 s. All groups were irrigated with a 100 cc saline solution for 2 min. Any procedure or treatment was not applied to Group I (Control). Group II (Burn Control) was only irrigated, Group III (SSD) was applied topical SSD 4 times, with 6-h intervals (at h 0, 6, 12 and 18), Group IV (Galangal) was applied topical AO 4 times, and Group V (Gel) was applied placebo topical material, used for the preparation of topical AO, 4 times. Wound healing findings were evaluated histopathologically. In the galangal group, it was found that collagen discoloration didn't penetrate into deep dermis compared to other groups; epidermis, hair follicles, and sebaceous glands remained protected compared to the burn control group, and there was a thicker layer of epidermis. It was found that the galangal group was the closest group to the control group histologically. In the galangal group, it was determined that the number of vessels and total hair follicles were significantly higher in the 8th h and 4th h respectively (p<0.05), while epidermal thickness and number of degenerated hair follicles were significantly higher in all hours compared to other three groups (p<0.05). It was determined that galangal group had the lowest scores in the evaluation of edema, polymorphonuclear leukocytes infiltration, collagen discoloration, injury of vessels, hair follicles and sebaceous glands in comparisons between groups and within groups' own processes. Administrating AO containing gel 4 times a day within the first 24 h is effective in the experimental contact type second degree burn model. It is significantly superior to SSD treatment, especially in the first 8 h of administration.

The effects of Beeswax, Olive oil and Butter impregnated bandage on burn wound healing

BackgroundBeeswax, Olive oil and Butter (BOB) are nutritive products that could support wound healing by adsorption to bandage. This study demonstrated the therapeutic effects of BOB on second degree burn. MethodsSecond degree burn model was created in rats. Experimental groups were assigned to Healthy, Burn, Silver Sulfadiazine (SS) and BOB. The effects of BOB were evaluated on skin regeneration, vesicles and bullae and fibroblast activity by histopathological analyses and wound contraction percent were determined. Transforming Growth Factor-Beta1 (TGF-β1) and Vascular Endothelial Growth Factor-alpha (VEGF-α) mRNA expressions were analyzed with Real Time-Polymerase Chain Reaction. All parameters analyzed at 3rd, 7th, 14th days. ResultsThe BOB treatment increased TGF-β1 and VEGF-α expressions compared to Burn group. The histopathological analyses showed that epidermis and dermis layers injured due to burn. BOB treatment augmented the regeneration of these layers and increased fibroblast activity and keratinization which are play important role on the new blood vessels production. Also with the BOB treatment we showed wound contraction levels were higher than Burn and SS treatment. ConclusionThis study demonstrated that beeswax–olive oil–butter mixture impregnated bandage treatment in a second-degree burn rat model improved burn wound healing and encouraged skin renewal via modulating tissue TGF-β1 and VEGF-α.

Topical Application of Lactobacillus plantarum on Burn Wound Healing in Diabetic Rats

Objective- This study was designed to investigate the effect of Lactobacillus plantarum gel on cutaneous burn wound healing in diabetic rats.Design- Randomized experimental studyAnimals- Forty adult male ratsProcedures- Two circular 1 cm cutaneous wounds were created in the dorsum back of each rat. 48 h post-burning, debridement with a 1 cm biopsy punch was performed. The wounds were divided into the following four treatment groups (n= 10, each): 1. Untreated or negative control (NC), 2. silver sulfadiazine (positive control-SSD), 3. base gel (BG) 4. Lactobacillus plantarum Gel (LP gel). The wound surface area and epithelialization were monitored. The animals were euthanized at 10 (n = 5), and 20 (n = 5) days post-injury (DPI) and the skin samples were used for histopathological, biochemical, TGF-β gene expression and biomechanical investigations. Results- It was indicated that the L. plantarum and SSD treated lesions had the lowest percentage of wound size and collagen content and also the L. plantarum treated group showed shortest inflammatory period and highest amount of TGF-β at 10 days post injury. The L. plantarum gel treated lesions also demonstrated greater ultimate load compared to the untreated and based gel treated wounds.Conclusions and Clinical Relevance- In conclusion, L. plantarum gel therapy improved wound healing and resulted in better outcomes after severe burn injury in diabetic rats compared with the silver sulfadiazine treatment.

Heterogeneity of mast cells and expression of Annexin A1 protein in a second degree burn model with silver sulfadiazine treatment.

Mast cells (MCs) participate in all stages of skin healing and one of their mediators is the Annexin A1 protein (AnxA1), linked to inflammation, proliferation, migration and apoptosis processes, but not studied in thermal burns yet. Therefore, our objectives were to evaluate the behavior of MCs and AnxA1 in a second degree burn model, treated or not with silver sulfadiazine 1% (SDP 1%) and associated to macrophages quantification and cytokines dosages. MCs counts showed few cells in the early stages of repair but increased MCs in the final phases in the untreated group. The normal skin presented numerous tryptase-positive MCs that were reduced after burning in all analyzed periods. Differently, few chymase-positive MCs were observed in the early stages of healing, however, increased chymase-positive MCs were found at the final phase in the untreated group. MCs also showed high immunoreactivity for AnxA1 on day 3 in both groups. In the tissue there was a strong protein expression in the early stages of healing, but in the final phases only in the SDP treated animals. TNF-α, IL-1β, IL-6, IL-10 and MCP-1 levels and macrophages quantification were increased in inflammation and reepithelialization phases. Reduced IL-1β, IL-6 and IL-10 levels and numerous macrophages occurred in the treated animals during tissue repair. Our results indicate modulation in the profile of MCs and AnxA1expression during healing by the treatment with SDP 1%, pointing them as targets for therapeutic interventions on skin burns.

Evaluation of the wound healing potential of Aloe vera-based extract of Nerium oleander.

OBJECTIVE:Nerium oleander (Apocynaceae) and Aloe vera (Liliaceae) are among the widely used herbal remedies for treating skin diseases and possess numerous activities such as antibacterial, antiviral, antifungal, and antioxidant. The aim of this study was to investigate the possible wound healing effect of Aloev era-based extract of the N. oleander leaf (NAE-8®) based on its antioxidant, anti-inflammatory, and DNA repair capacity along with histological changes and to compare them with the traditional silver sulfadiazine treatment (SSD).METHODS:Twenty-four Wistar albino rats were randomly grouped as follows: i) control, ii) burn alone (burn), iii) burn with topical NAE-8® (burn+NAE-8®) treatment, and iv) burn with topical 1% silver sulfadiazine (burn+SSD) treatment. All groups received their related topical application twice a day for 14 consecutive days. Upon completion of the experimental protocol, trunk blood and skin tissues were collected for measuring malondialdehyde (MDA), glutathione (GSH), myeloperoxidase (MPO), tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), %DNA in the tail (%DNAT) levels along with histological examinations.RESULTS:Thermal injury-induced alterations in MDA, GSH, MPO, TNF-α, IL-1β, and %DNAT levels were significantly reversed by NAE-8® treatment. These ameliorative effects were also supported by histological findings.CONCLUSION:Findings of the present study suggest that NAE-8® is a promising remedy for treating skin burn injury.

Assessment of Deep Partial Thickness Burn Treatment with Keratin Biomaterial Hydrogels in a Swine Model.

Partial thickness burns can advance to full thickness after initial injury due to inadequate tissue perfusion and increased production of inflammatory cytokines, which has been referred to as burn wound progression. In previous work, we demonstrated that a keratin biomaterial hydrogel appeared to reduce burn wound progression. In the present study, we tested the hypothesis that a modified keratin hydrogel could reduce burn wound progression and speed healing. Standardized burn wounds were created in Yorkshire swine and treated within 30 minutes with keratin hydrogel (modified and unmodified), collagen hydrogel, or silver sulfadiazine (SSD). Digital images of each wound were taken for area measurements immediately prior to cleaning and dressing changes. Wound tissue was collected and assessed histologically at several time points. Wound area showed a significant difference between hydrogels and SSD groups, and rates of reepithelialization at early time points showed an increase when keratin treatment was used compared to both collagen and SSD. A linear regression model predicted a time to wound closure of approximately 25 days for keratin hydrogel while SSD treatment required 35 days. There appeared to be no measurable differences between the modified and unmodified formulations of keratin hydrogels.

Investigation of acute effects of Hypericum perforatum (St. John's Wort-Kantaron) treatment in experimental thermal burns and comparison with silver sulfadiazine treatment.

Hypericum perforatum (HP) (St. John's Wort-Kantaron) has been used widely for the treatment of burn injuries for many years in traditional Turkish medicine. The aim of study was to investigate HP treatment in experimental thermal burns and compare it with silver sulfadiazine (SS) treatment.Thirty-five rats were randomly assigned to one of the five groups, 7 rats in each. A second-degree thermal burn was created on the dorsal sites of rats by exposing an area of 4×4 cm to 100 °C boiled water for 10 seconds. All groups were provided with irrigation for three (3) minutes with 50 cc saline solution (SS). Group 1 (Control Group) was not administered any treatment. Group 2 (Burn Control Group) was administered only irrigation, Group 3 (topical silver sulfadiazine [SS]) was administered SS twice a day, Group 4 (the Topical HP Group) was administered HP four times a day (every six hours), Group 5 (treatment with agent -gel-) was administered other topical material used for the preparation of HP four times a day (every six hours). Wound site healing on the skin was histopathologically evaluated.It was found that collagen discoloration of the HP treatment group was localized in the lower part of the epidermal layer and did not go up to the depth of dermis compared to the other groups, and epidermis, hair follicles and sebaceous glands remained protected compared to the groups administered burn, gel and SS in every hour of the experiment and it was the group closest to the control group structurally. It was determined that the epidermal thickness and the number of vessels of the HP Group were significantly higher compared to the other groups (p<0.05), which was the group closest to the control group in terms of these parameters and these numbers did not show any difference within hours (p>0.05). The number of degenerated hair follicles in the HP Group was significantly less than the other groups (p <0.05), and it was determined that the total number of hair follicles significantly increased in the twenty-fourth (p<0.05) and this number did not differ by the control group (p>0.05).Administration of HP four times a day within the first 24 hours is clearly effective in wound healing in the experimental thermal second degree burn modality and is significantly superior to SS treatment.

Evaluation of Wound Healing Effect of &lt;i&gt;Punica granatum&lt;/i&gt; L Peel Extract on Deep Second-Degree Burns in Rats

Purpose: To investigate the healing effect of Punica granatum L. peel (Pomegranate husk) extract (PHE) on deep second-degree burns in rats.Methods: Male Wistar rats, weighing 220 – 240 g, were subjected to deep second-degree skin burns by electrical scald instrument. The animals were divided into three groups as follows: (1) deep second degree burn model (control) group, (2) burns model treated with 1 % silver sulfadiazine (SSD) group, and (3) burns model treated with PHE group. On days 3, 7, 14 and 21, animal weight, wound area as well as histopathological features of skin were evaluated for all the groups. Minimum inhibitory concentration (MIC) of PHE on Staphyloccocus aureus, Pseudomonas aeruginosa and Escherichia coli were also assessed separately.Results: On day 21, the mean wound area of PHE treatment group (0.21 ± 0.07 cm2) and SSD treatment group (1.15 ± 0.1 cm2) were significantly smaller than that of control rats (2.42 ± 0.2 cm2, p < 0.01) respectively. Histological results indicate that inflammatory cells disappeared substantially and were replaced by new granulation tissue in PHE treatment or SSD treatment group, while that of the control rats still showed severe inflammatory cell infiltration. Antibacterial test revealed that the MIC of PHE on Staphyloccocus aureus, Pseudomonas aeruginosa and Escherichia coli was 6.25, 12.5 and 6.25 mg•mL-1, respectively.Conclusion: The results reveal that PHE is an effective and promising medicinal herb for the management of deep second degree burns.Keywords: Punica granatum L. peel, Burns, Wound area, Healing, Antimicrobial activity

Investigation of acute effects of Hypericum perforatum (St. John's Wort-Kantaron) treatment in experimental thermal burns and comparison with silver sulfadiazine treatment.

Hypericum perforatum (HP) (St. John's Wort-Kantaron) has been used widely for the treatment of burn injuries for many years in traditional Turkish medicine. The aim of study was to investigate HP treatment in experimental thermal burns and compare it with silver sulfadiazine (SS) treatment. Thirty-five rats were randomly assigned to one of the five groups, 7 rats in each. A second-degree thermal burn was created on the dorsal sites of rats by exposing an area of 4×4 cm to 100 °C boiled water for 10 seconds. All groups were provided with irrigation for three (3) minutes with 50 cc saline solution (SS). Group 1 (Control Group) was not administered any treatment. Group 2 (Burn Control Group) was administered only irrigation, Group 3 (topical silver sulfadiazine [SS]) was administered SS twice a day, Group 4 (the Topical HP Group) was administered HP four times a day (every six hours), Group 5 (treatment with agent -gel-) was administered other topical material used for the preparation of HP four times a day (every six hours). Wound site healing on the skin was histopathologically evaluated. It was found that collagen discoloration of the HP treatment group was localized in the lower part of the epidermal layer and did not go up to the depth of dermis compared to the other groups, and epidermis, hair follicles and sebaceous glands remained protected compared to the groups administered burn, gel and SS in every hour of the experiment and it was the group closest to the control group structurally. It was determined that the epidermal thickness and the number of vessels of the HP Group were significantly higher compared to the other groups (p<0.05), which was the group closest to the control group in terms of these parameters and these numbers did not show any difference within hours (p>0.05). The number of degenerated hair follicles in the HP Group was significantly less than the other groups (p <0.05), and it was determined that the total number of hair follicles significantly increased in the twenty-fourth (p<0.05) and this number did not differ by the control group (p>0.05). Administration of HP four times a day within the first 24 hours is clearly effective in wound healing in the experimental thermal second degree burn modality and is significantly superior to SS treatment.

Healing of burn wounds by topical treatment: A randomized controlled comparison between silver sulfadiazine and nano-crystalline silver.

Background:Silver sulfadiazine (SSD) has been the standard topical antimicrobial for burn wounds for decades. Recently, nanometer-sized silver particles are available which have high surface to volume ratio and remain effective even at a very low concentration and minimizes the chance for tissue toxicity due to silver. Hence, we conducted a randomized controlled trial to compare the effectiveness of topical SSD and nano-crystalline silver (AgNP) hydrogel in burn wounds management.Materials and Methods:Study was conducted in the Burn Unit of IPGME&R & SSKM Hospital Calcutta, from January 2011 to August 2012. Patients with 2° burn injury were randomly allocated to SSD and AgNP treatment group. Clinical assessments of burn wound were done on every week till 4th week and on completion of treatment.Results:Data for evaluation were obtained for 54 patients on SSD (2° deep-dermal cases 27) and 52 (2° deep-dermal cases 31) on AgNP treatment. Healing status of 2° deep-dermal burns was more satisfactory for AgNP group than SSD treatment at 4 weeks. Among patients receiving AgNP, 80.6% showed at least 50% healing of 2° deep-dermal wounds compared to 48.1% on SSD at 4 weeks (P = 0.001). The figures for complete healing at 4 weeks were, respectively, 4% and 0% (P = 0.116).Conclusions:AgNP can be an effective and superior alternative to SSD for burn wounds, particularly 2° deep-dermal burns. Healing can be expected, in general, in 6 to 8 weeks time, depending upon the extent of body surface involvement.

Investigation of Acute Effects of Hypericum Perforatum (Kantaron) Treatment in Experimental Thermal Burns and Comparison with Silver Sulfadiazine Treatment

Investigation of Acute Effects of Hypericum Perforatum (Kantaron) Treatment in Experimental Thermal Burns and Comparison with Silver Sulfadiazine Treatment

Topical petrolatum gel alone versus topical silver sulfadiazine with standard gauze dressings for the treatment of superficial partial thickness burns in adults: A randomized controlled trial

BackgroundNon-extensive superficial partial thickness burns constitute a major proportion of burns. Conventional treatment involves regular changing of absorptive dressings including the application of a topical antimicrobial, commonly silver sulfadiazine. A systematic review has found insufficient evidence to support or refute such antimicrobial prophylaxis. Another review compared silver sulfadiazine dressings with other occlusive and non-antimicrobial dressings and found insufficient evidence to guide practice. Other research has suggested that dressings with petrolatum gel are as effective as silver sulfadiazine. MethodsSingle-center, randomized, controlled parallel group trial comparing conventional silver sulfadiazine dressings with treatment with petrolatum gel alone. Consenting adults 18–45 years old with superficial partial thickness burns ≤10% total body surface area seen within 24h of the injury were randomized to daily dressing either with petrolatum gel without top dressings or conventional silver sulfadiazine treatment with gauze dressings. Primary outcomes were blinded assessment of time to complete re-epithelialization, wound infection or allergic contact dermatitis. Secondary outcomes included assessment of ease, time and pain of dressing changes. Results26 patients were randomized to petrolatum and 24 to silver sulfadiazine dressings. Follow up data available for 19 in each group. Mean time to re-epithelialization was 6.2 days (SD 2.8) in the petrolatum group and 7.8 days (SD 2.1) in the silver sulfadiazine group (p=0.050). No wound infection or dermatitis was observed in either group. Scores for adherence to wound, ease of dressing removal and time required to change dressings were significantly better in the petrolatum treatment arm (p<0.01). ConclusionsPetrolatum gel without top dressings may be at least as effective as silver sulfadiazine gauze dressings with regard to time to re-epithelialization, and incidence of infection and allergic contact dermatitis. Petrolatum gel appears to be an effective, affordable and widely available alternative in the treatment of minor superficial partial thickness burns in adults.