Topical Wound Care Research Articles

An injectable hydrogel of porcine cholecyst extracellular matrix for accelerated wound healing.

Hydrogel formulations of xenogeneic extracellular matrices have been widely used for topical wound care because of their exceptional tunability over other formulations like lyophilized sheets, powders, non-injectable gels, pastes, and ointments. This is important in the treatment of wounds with irregular shapes and depth. This study identified an injectable hydrogel formulation of porcine cholecyst extracellular matrix (60%) in medical-grade carboxymethyl cellulose (40%) as vehicle and evaluated its biomaterial properties. Further, an in-depth evaluation of in vivo wound healing efficacy was conducted in a rat full-thickness skin excision wound healing model, which revealed that the hydrogel formulation accelerated wound healing process compared to wounds treated with a commercial formulation and untreated wounds. The hydrogel appeared to have promoted a desirable pro-regenerative tissue reaction predominated by Th2 helper lymphocytes and M2 macrophages as well as an effective collagen remodeling indicative of diminished scarring. In conclusion, the porcine cholecyst extracellular matrix injectable hydrogel formulation appeared to be a promising candidate formulation as an advanced wound care biomaterial for faster healing of skin wounds with minimal scarring.

Fighting A New Front On An Old Battlefield: Examining the Development of Topical Antimicrobial Care to Control Burn Wound Sepsis.

Recognition of invasive burn wound sepsis as a major cause of morbidity and mortality in burn injured patients has profoundly changed the management of burn wounds and its associated complications. The development of effective topical antimicrobial therapy is one of the last major developments of modern burn care and has been driven by major world events and scientific breakthroughs. Topical antimicrobial burn care has evolved from the use of anecdotal remedies to scientific breakthroughs such as Moyer's successful dilution of silver nitrate solution, Fox's described benefit of silver sulfadiazine use in animal models, and Pruitt's dramatic improvement in post-burn mortality using topical mafenide acetate in burn wounds. The objective of this manuscript is to review the definition of burn wound sepsis and highlight the major developments and breakthroughs in topical burn wound care throughout history. This includes historical events like major wars or domestic fires that have influenced or impacted the understanding and treatment of burn wounds. Newer advances in topical antimicrobial care such as nanosilvers and dressing technologies that improve the morbidity and mortality associated with burn wound sepsis and novel approaches to management will also be discussed. To improve burn care, it is prudent to look to the past and learn from the experiences of those who contributed to the control of burn wound sepsis.

Formulation and Development of herbal Gel containing Cannabis sativa and Azadirachta indica leaves extract for Anti-inflammatory and Anti-bacterial activity

Bacteria are everywhere and play a crucial part in the maintenance of germs that cause illness and disease. Skin infections are anticipated to occur at a rate of 24.6 per 1000 people yearly. The treatment of any skin infections primarily consists of any necessary surgical debridement; nevertheless, injecting an antibiotic directly into a wound has several potential benefits. Topical antibiotic treatment and wound care are recommended. The administration of a therapy may allow treatment with medicines that are not yet available (or safe) for systemic therapy. Gels are semi-solid systems having qualities intermediate between solids and liquids, in which the movement of the dispersing medium is constrained by an interlacing three-dimensional network of particles or solvated macromolecules of the dispersed phase. This study aimed to explore the potential of Cannabis sativa, Azadirachta indica leaves extract as anti-inflammatory and antibacterial agents. The formulation has been developed by solvent casting method. The experiment was conducted using various techniques to measure the effectiveness of each substance individually and in combination. Results showed that Cannabis sativa and Azadirachta indica leaves extract both had strong anti-inflammatory properties, while glycerol demonstrated significant antibacterial activity. When combined, these substances exhibited enhanced anti-inflammatory and antibacterial effects, indicating potential for their use in pharmaceutical and medical applications. Overall, this study highlights the importance of exploring natural products for their therapeutic potential and provides insight into the potential of these substances as novel anti-inflammatory and antibacterial agents.

A Comparative Study Of Topical Phenytoin Versus Conventional Wound Care In Diabetic Ulcers

A Comparative Study Of Topical Phenytoin Versus Conventional Wound Care In Diabetic Ulcers

Pioneering Topical Ointment Intervention for Unprecedented Antimicrobial and Diabetic Wound Management with Phenylpropanoids and Nano-Silver.

Addressing the intertwined challenges of antimicrobial resistance and impaired wound healing in diabetic patients, an oil/water emulsion-based nano-ointment integrating phenylpropanoids-Eugenol and Cinnamaldehyde-with positively-charged silver nanoparticles was synthesized. The process began with the synthesis and characterization of nano-silver, aimed at ensuring the effectiveness and safety of the nanoparticles in biological applications. Subsequent experiments determined the minimum inhibitory concentration (MIC) against pathogens such as Streptococcus aureus, Pseudomonas aeruginosa and Candida albicans. These MIC values of all three active leads guided the strategic formulation of an ointment base, which effectively integrated the bioactive components. Evaluations of this nano-ointment revealed enhanced antimicrobial activity against both clinical and reference bacterial strains and it maintained stability after freeze-thaw cycles. Furthermore, the ointment demonstrated superior in-vitro diabetic wound healing capabilities and significantly promoted angiogenesis, as shown by enhanced blood vessel formation in the Chorioallantoic Membrane assay. These findings underscore the formulation's therapeutic potential, marking a significant advance in the use of nanotechnology for topical wound care.

Double Z-Rhombic Plasty for Repair of Scalp Defects.

The closure of scalp wounds presents with reconstructive challenges due to the poor tissue elasticity. It is not uncommon to require skin grafts for definitive closure, even when large flaps are employed. Herein, we present a novel method for the direct closure of small- to medium-sized wounds defects. It is a modified bilateral rhomboid flap, which enables tension-free closure in many areas of scalp. All patients treated with this technique between January 2018 and January 2023 were reviewed. Demographics, complications, and outcomes were reviewed. One hundred forty patients have been operated with this technique. All have been cases of skin tumors. The full flap survival was 97.14%, and they did not present any major local complications, avoiding in all cases the use of skin autografts. Four patients (2.86%) had partial necrosis in the edges of the flap, all managed with topical wound care with good healing and no need of secondary procedures. This flap is safe and easy to perform when there is skin laxity in the scalp. It can save many skin grafts, simplifying the closure of this area, which can be a first-choice technique on scalp reconstruction.

All-in-one tissue adhesive hydrogels for topical wound care

An adhesive tissue sealant that enables rapid formation of new granulation tissue while leading to additional synthesis of extracellular matrix (ECM) to promote tissue regeneration is strongly required in the clinical field. This study presents an all-in-one wound care hydrogel sealant that generates cohesion in response to pH change while adhering stably to tissue. To fulfill this, we employ an injectable boronic acid-conjugated alginate (Al-BA) aqueous sol phase that turns into a soft viscoelastic hydrogel gel phase at physiological pH conditions, thus filling in wounds of any size or depth. Positively charged bacterial cellulose nanofibers ((+)BCNF) are incorporated to reinforce this gel. Compared to the only Al-BA adhesive, the resulting Al-BA/(+)BCNF adhesive hydrogel exhibits substantial adhesion strength while retaining the wound closure even with external mechanical perturbation such as stretching, bending and twisting. Furthermore, in vitro and in vivo wound healing evaluations revealed that fibrous (+)BCNF provides favorable microenvironment for cell migration and proliferation similar to collagen fibers, promoting wound healing and skin regeneration.

Evaluation of pain associated with the application of burn dressings.

Topical wound care after burn injury has revolutionized burn care. Dressings and topical solutions provide broad-spectrum antimicrobial coverage to prevent wound infection, be easy to apply and remove, and promote wound healing. A wide variety of dressings are available for providers to choose from based on wound characteristics. An additional factor to consider when making that decision is any pain associated with applying the dressing and frequency of dressing changes. This retrospective study aimed to examine the daily and maximum pain reported by patients and daily opioid consumption to determine if there are any differences among commonly used dressings including 5% sulfamylon solution (SMS), manuka honey, negative-pressure wound therapy (NPWT), silver sulfadiazine, and silver nylon. This study demonstrated that silver sulfadiazine had lower mean daily pain scores compared only to manuka honey as well as lower maximum scores when compared to all other dressings except silver nylon. Furthermore, the choice of dressing did not have an overwhelming effect on the amount of opioids consumed by patients during their hospital stay with manuka honey having less opioid consumption when compared to only 5% SMS and NPWT only. Further studies are needed with additional validated pain assessment tools and clinically relevant endpoints to fully elucidate the impact of burn dressings and other topical wound care options on pain.

Prevalence of Consumers Purchasing Antibiotic Medicine Without Prescription Among Community Pharmacies

According to the Global Research on Antimicrobial Resistance, the Philippines has an average antibiotic use of 5.3 DDDs per 1,000 people, with pediatric antibiotic use constituting approximately 56.2%. Although lower than in neighboring countries, this level of use still poses a significant threat to the healthcare system. The widespread availability of antibiotics has been a major contributing factor to the rise of antibiotic resistance (ABR) in the Philippines. Historically, antibiotics could be purchased without a prescription from local pharmacies. This study examined the prevalence of consumers attempting to purchase antibiotics without a prescription in Carmona, Cavite. Utilizing quantitative descriptive and correlational research methodologies, the study employed convenience sampling due to the limited number of community pharmacies and their tendency to cluster in specific areas. A structured survey questionnaire was used to gather data and analyze correlations between variables. Findings indicate that the majority of consumers in Carmona, Cavite, frequently attempt to obtain antibiotics without a prescription, with a preference for penicillin-class antibiotics. The reasons for these purchases vary, including self-medication for minor illnesses, treatment for pets and poultry, and topical wound care. The results underscore the importance of community education and engagement on the risks of ABR. The study suggests that local government educational programs can enhance consumer awareness of the need for prescriptions. The findings indicate that awareness of prescription requirements moderately affects the frequency of attempting to buy antibiotics without a prescription. However, no significant association was found between the reasons for obtaining medicine without a prescription and the type or class of medicine purchased.

A collagen-based layered chronic wound biofilm model for testing antimicrobial wound products.

A new in vitro chronic wound biofilm model was recently published, which provided a layered scaffold simulating mammalian tissue composition on which topical wound care products could be tested. In this paper, we updated the model even further to mimic the dynamic influx of nutrients from below as is the case in a chronic wound. The modified in vitro model was created using collagen instead of agar as the main matrix component and contained both Staphylococcus aureus and Pseudomonas aeruginosa. The model was cast in transwell inserts and then placed in wound simulating media, which allowed for an exchange of nutrients and waste products across a filter. Three potential wound care products and chlorhexidine digluconate 2% solution as a positive control were used to evaluate the model. The tested products were composed of hydrogels made from completely biodegradable starch microspheres carrying different active compounds. The compounds were applied topically and left for 2-4 days. Profiles of oxygen concentration and pH were measured to assess the effect of treatments on bacterial activity. Confocal microscope images were obtained of the models to visualise the existence of microcolonies. Results showed that the modified in vitro model maintained a stable number of the two bacterial species over 6 days. In untreated models, steep oxygen gradients developed and pH increased to >8.0. Hydrogels containing active compounds alleviated the high oxygen consumption and decreased pH drastically. Moreover, all three hydrogels reduced the colony forming units significantly and to a larger extent than the chlorhexidine control treatment. Overall, the modified model expressed several characteristics similar to in vivo chronic wounds.

551 Reduction of Fungus-Related Complications in a Burn Center

Abstract Introduction Fungal wound infections (FWI) cause morbidity and increase mortality in burn patients. Our burn center experienced 44 patients with fungal wound colonization (FWC) and/or FWI between JAN 2015 and JAN 2019. In response, we undertook a performance improvement project to prevent and treat FWC and FWI. Methods Members of the multidisciplinary team met to develop a clinical practice guideline (CPG) for the prevention and management of FWC and FWI based on current evidence. We focused on patients with elevated risk, that is, with burns ≥20% total body surface area (TBSA) and in the Burn ICU (BICU). Interventions included: utilizing alternating silver sulfadiazine and mafenide acetate creams upon admission; reducing the use of mafenide acetate solution; utilizing silver nitrate solution post-operatively; and applying topical nystatin cream or powder for suspected FWC or FWI. We educated all staff members and updated order sets and training materials. We collected data on all burn patients who had a wound biopsy out of concern for possible infection. Biopsy results were categorized as FWC or FWI. Retrospective data were collected for MAR 2020 - MAR 2021 (PRE). Post-implementation, prospective data collection began MAR 2022 (POST) and will continue for one year. Adherence to the CPG was assessed by chart review. Mann-Whitney and Fischer Exact tests were performed. Results The PRE (n=15) and POST (n=9) groups were similar in age (43±13 vs. 48±18 years) but differed in TBSA (49±19 vs 28±25%, p< .05). PRE group biopsies showed FWC in 0 patients and FWI in 11 of 15 patients (73%); 8 of these (53%), all with FWI, died. In the POST group, FWC was found in 1 patient (11%) and FWI was found in 2 of 9 patients (22%); one death occurred in the patient with FWC. Adherence to the CPG for admission topical wound care was 7% in the PRE group vs 89% in the POST group (p=0.0001); adherence to the CPG for day-of-biopsy topical wound care was 27% in the PRE group vs 89% in the POST group (p< 0.01). Conclusions Adherence to a CPG for the prevention and treatment of FWC and FWI was associated with a lower (but not statistically significant) prevalence of these complications. Limitations include a difference in the TBSA between the 2 groups and potential concurrent changes in practice. Ongoing data collection includes the evaluation of other potential contributing factors. Applicability of Research to Practice Fungi are common in the environment, and when combined with immunosuppression and extensive open wounds, may cause wound infection in burn patients. More research is needed to further evaluate effective treatments for the prevention and treatment of FWC and FWI in these patients.

546 Winning the Race Against Pathogens: A Regional Burn Center Experience with a Cleansing Protocol

Abstract Introduction The skin is the first immune defense mechanism, and it functions as a barrier against various microorganisms. Burn injury will compromise this important barrier. Infections are the primary factor contributing to burn mortality, resulting in >50% of deaths in burn patients. In 2020, our Adult and Pediatric Burn Center instituted a pure Hypochlorous Acid (pHA) antimicrobial protocol to enhance skin barrier function. Methods We conducted a retrospective analysis on the effect of the introduction of the pHA protocol on the number of reportable infections in our Burn Center. The period of observation in this report is 2017-2021. Beginning in 2020, adults and children received topical wound care and bathing with our pHA protocol. No dilution of the product was used. The product was placed into a sterile basin and the patient was cleaned head to toe, including the genitalia and the wounds. Since invasive procedures such as placement of central venous catheters or urinary collection catheters may be a conduit of infection, the present report includes data regarding the number of patients experiencing clostridium difficile, central line-associated blood stream infection and catheter-associated urinary tract infections. Results From 2017-2021, our Burn Center admitted 2,223 patients. We computed a percent change in infections from before (2017-2019) to after (2021) the pHA protocol was implemented. We used 2021 because this was the first full year after the pHA protocol was introduced. We subtracted the total number of infections in 2021 from the average number of infections per year in 2017-2019 and divided by the average number of infections per year in 2017-2019. We found a 55% decrease in infections after the pHA protocol was introduced. There was no evidence of toxicity in adult or pediatric patients associated with care during introduction of the pHA protocol, including skin graft sites. Conclusions This analysis indicates a notable decrease in infections. The pHA procedure shows no evidence of viral, fungal or bacterial pathogens causing significant issues with the studied patient group. This analysis does not determine whether the decrease in infections is clinically or statistically significant. Applicability of Research to Practice Reducing infections in burn patients which can be life saving.

The Effect of Honey and Zinc Cream as Topical Dressing for Epithelization in Diabetic Foot Ulcer

ABSTRACT Diabetic foot ulcer is a complication that often serves Diabetes Mellitus patients. Currently, wound care has used dressings to keep the wound environment moist, but in general, foot wound care requires high costs, so it is necessary to figure out the alternative wound care that is really effective and cost-effective in wound healing. One type of alternative therapy for topical treatment of diabetic foot ulcers that can be used is topical honey. The aim of this research was to identify the effect of topical honey and zinc cream on epithelization in the treatment process for diabetic foot ulcers. This type of research is inquiries, namely intervention, and control group design. The sample consisted of 60 respondents consisting of 30 wound care groups using topical honey and 30 wound care respondents using zinc cream with the sampling technique, namely consecutive sampling. Honey was used with 87% honey concentration and lipid tissue epithelialization was measured using the Bates Jensen Wound Access Tool (BJWAT). Data analysis used the Mann-Whitney test as an alternative test for the independent t-test. The results showed that there was no significant difference in wound tissue epithelialization between the wound care group with zinc topical cream and honey topical cream (p-value> 0.05). The Conclusions which is based on the results of analytical tests, wound care using topical zinc cream and topical wound care using honey did not have a significant difference in the epithelialization process of diabetic foot ulcers, but clinically the epithelialization process of diabetic foot wounds with topical honey treatment was faster than using zinc cream. It is recommended that topical wound care using honey can be used as an alternative topical in the treatment of diabetic foot ulcers. Keywords: Diabetic Foot, Honey, Ulcer, Zinc Cream

Use of a Novel Purified Reconstituted Bilayer Matrix for Treatment of Chronic Diabetic Foot Ulcers: A Retrospective Case Series

Background. With the lifetime risk of DFU being 34% and the rate of chronic wounds increasing, there is a need for advanced therapies offering rapid, reliable, and safe healing. Materials and Methods. A retrospective review was performed of 10 cases in which a novel PRBM was used for treatment of chronic DFUs. Patients who presented with DFUs refractory to topical wound care and offloading for longer than 4 weeks received weekly application of PRBM for up to 12 weeks along with a standard treatment regimen at a single outpatient center. At weekly visits, the wound was measured, inspected for signs of complications, cleaned, and debrided as necessary, followed by PRBM application until complete epithelialization or for 12 applications. The primary outcome was complete wound closure at 12 weeks. Secondary outcomes included time to closure, DFU percent area reduction, and material cost to closure. Results. Mean wound healing time was 6.1 weeks, with 90% of wounds closed at 12 weeks. Six wounds were healed at 6 weeks, 2 at 7 weeks, and 1 at 12 weeks. One wound did not close over the study period. Mean wound area reduction was 85% at 6 weeks and 94% at 12 weeks. Patients tolerated PRBM application with no reported pain or discomfort. No adverse events were reported. Mean PRBM cost to closure for healed wounds was $2624. Conclusions. Treatment of chronic DFUs with PRBM is safe and efficient to achieve complete healing.

The effectiveness of topical hyaluronic acid on decreasing Interleukin-6 and acceleration of wound healing (Push Score) in Wagner II-III diabetic foot ulcer in Dr. Soetomo Hospital Surabaya

Background: A diabetic foot ulcer is a complication that often occurs in patients with diabetes mellitus. The healing process of a chronic wound is more complicated and requires more complex treatment. There is an increase in IL-1, IL6, and TNF-α pro-inflammatory cytokines in a chronic wound. Hyaluronic acid (HA) is a component that has been used for a long time and is known to help the wound healing process. This study was at a time to determine the effectiveness of hyaluronic acid on the reduction of interleukin-6 in accelerating the healing of Wagner II-III diabetic foot ulcers. Methods: This study is an experimental, randomized study of pre and post-test design on diabetic foot ulcer patients with the Wagner II-III classification who were controlled at the thoracic, cardiac, and vascular surgery polyclinic at Dr. Soetomo Hospital Surabaya. Data were analyzed using SPSS version 20 for Windows. Result: About 39 samples are willing to participate in the study, divided into 20 samples in the treatment group and 19 in the control group. The mean concentrations of IL-6 in the treatment group before and after the intervention were 280.70±155.50 ng/ml and 126.60±145.60 ng/ml. There was a significant decrease in IL-6 levels (p<0.05) before and after the intervention. The mean concentrations of IL-6 in the control group pre and post were 315.20±127.40 ng/ml and 136.30±134.60 (p<0.05). The decrease in the control and treatment groups was no statistically significant difference (p>0.05). There was no significant difference in the PUSH Score (p>0.05) in the two groups before intervention/treatment. The decrease of wound area in the control and treatment groups were -4.80 ((-0.40)-(-24.50)) and -4.8 ((-0.70)-(-30.90)) (p>0.05). Conclusion: Topical hyaluronic acid and wound care using 0.9% NaCl reduced interleukin-6 levels, PUSH scores, and wound area in Wagner II-III diabetic foot ulcers.

Modern technologies of venous ulcers treatment in elderly population

Venous trophic ulcers take place in the terminal stage of chronic venous insufficiency. The problem of venous trophic disorders is extremely relevant due to the high prevalence among the population. This review considers the comparative characteristics of morbidity data on the example of Germany and the Russian Federation. Particular attention paid to the influence of the course of the disease on patient’s life quality during treatment. The causes of high-cost treatment are reported with approximate calculations for 1 clinical case and total annual costs according to foreign researchers (Australia, Great Britain, USA). The risk factors are discussed in the form of certain concomitant nosologies that significantly aggravate the healing process of ulcers with a brief description of the pathogenesis. The review defines the main goals of the treatment of venous trophic ulcers, as well as separate groups of directions in which it is reasonable to carry out therapeutic measures. Article presents a comparative analysis between the methods of applying compression therapy (elastic bandaging, the use of special stockings) and the influence of the choice on the quality of life of patients. Various methods of topical wound care are described with the obligatory consideration of the stage of the wound process, alternative methods of local treatment are listed (for example, the use of autologous platelet-rich plasma). The efficacy of systemic pharmacotherapy in trophic disorders and the treatment potential of various groups of drugs on the rate of ulcer healing were evaluated. The advantages of using surgical treatment are determined, the main surgical techniques are listed, highlighting the advantages and disadvantages of each. Possible treatment strategies for elderly patients also discussed. The complexity of evaluating the effectiveness of new techniques and an integrated approach to treatment is shown, which in the future will help to correct the direction of finding new ways to solve the problem of venous ulcers in this specific group of patients.

Revolutionizing non-conventional wound healing using honey by simultaneously targeting multiple molecular mechanisms.

Hospital-acquired infections and treatment-related wound complications constitute a tremendous burden for the health care system, particularly given the serious increase in multidrug resistant pathogens. Imagine that a large part of nosocomial infections can be prevented using a simple treatment. In this respect, honey is used mainly in topical cutaneous wound care because of its potent broad-spectrum antibacterial and wound healing activities. However, therapeutic use outside this scope has been limited. The current review provides an in-depth view of studies using honey outside the conventional wound care indications. Non-conventional routes of honey application include subcutaneous, intra-socket, abdominal, and oral administration in novel indications, such as post colon surgery, mucositis, and tooth extraction. Honey consistently demonstrates beneficial therapeutic activities in these novel applications, orchestrating antimicrobial and prophylactic activity, reducing inflammation and wound dehiscence, and inducing healing, epithelialization, and analgesic activity. Several molecular mechanisms are responsible for these beneficial clinical effects of honey during the course of wound healing. Pro-inflammatory effects of honey, such as induction of iNOS, IL-1β, and COX-2, are mediated by TLR4 signaling. In contrast, honey's anti-inflammatory actions and flavonoids induce anti-inflammatory and antioxidant pathways by inducing NRF2 target genes, including HO-1 and PRDX1. The molecular and biochemical pathways activated by honey during the different phases of wound healing are also discussed in more detail in this review. Variation between different honey origins exists, and therefore standardized medical-grade honey may offer an optimized and safe treatment. Honey is a valuable alternative to conventional antimicrobial and anti-inflammatory therapies that can strongly reduce nosocomial infections.

Alternative Wound Management: Translating Science into Practice.

To present a scoping review of preclinical and clinical trial evidence supporting the efficacy and/or safety of major alternative wound care agents to summarize their effects on validated elements of wound bed preparation and wound management paradigms. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant will:1. Differentiate the effectiveness of the topical wound care agents included in this review.2. Compare the preventive efficacy of intravenous agents administered to trauma and surgical patients.3. Select the effectiveness of products in this review that are left in place after surgical procedures.4. Identify an oral agent that can be helpful in mitigating the effects of COVID-19.

English

BACKGROUND Wounds and their management are important in the practice of surgery. Super oxidised solution is a recent concept in wound management. It is an aqueous solution which is electrochemically processed which is non-toxic, non-irrigating and is having a neutral pH. Povidone iodine is the most common topical wound care product used in surgical practice. Both are affordable solutions for the patients. There are very few studies comparing the efficacy. In this study, we wanted to compare the efficacy of super oxidised solution and povidone iodine in the management of lower limb ulcers. METHODS A prospective study was conducted on 100 patients who were randomized into two groups. Group A was treated with super oxidized solution and Group B were treated with povidone iodine. Assessments of wounds were done on various days (1, 3, 5, 7, 9, 12, 15, 18, 21). Various outcomes of data were analysed using statistical analysis. RESULTS The average percentage reduction in wound size on day 21 was 47 % in Group A compared to 24 % in Group B. Early appearance of granulation tissue, disinfection, decrease in wound size, and less duration of hospital stay was achieved in Group A. CONCLUSIONS The results were more favourable towards super oxidised solution than povidone iodine. In this comparative study, super oxidized solution had faster efficacy and wound healing in patients than povidone iodine. KEY WORDS Super Oxidized Solution, Ulcer, Povidone Iodine.

Preparation and characterization of Terminalia bellerica loaded PCL nanofibrous mats for biomedical applications

Wounds are big challenges to the wound care professionals. Topical wound care products and wound dressings are evolved every day. Advanced dressings are produced by incorporating antimicrobial agents, growth factors and herbal extracts to enhance the wound healing process. Nanofibres are the recent focus as drug delivery vehicle for the delivery of drugs to the target site. The aim of the study is to prepare Terminalia bellerica loaded PCL nanofibrous mats by electrospinning and to characterize the nanofibres for biomedical applications. Terminalia bellerica is one of the ingredients of Triphala which play important role as rejuvenating agent. The increasing concentration of Terminalia loaded PCL nanofibrous mats shows increased fiber diameter, wettability and Water uptake property. The wettability of the PCL was decreased from 113.3 ± 3.62 to 59.98 ± 4.99, 44.96 ± 7.04 and 34.34 ± 3.45 respectively for the Terminalia loaded PCL nanofibres. The 5% herbal loaded PCL nanofibrous mats shows antimicrobial activity against gram negative bacteria. Further, Terminalia loaded PCL mats were found to be nontoxic and is responsible for the cell adhesion and proliferation and is useful as the potential candidate for wound dressing applications.