Dipyridamole inhibits early wound healing in rat skin incisions

Assessment of Toxicity and Wound Healing Activity of Selaginella Bryopteris Extract

AIM

The aim of the study was to assess the toxicity profile of Selaginella bryopteris extract and evaluate its wound healing activity.

METHODS

In vitro wound healing activity of S. bryopteris extract (5% and 10%) was performed using Clonogenic and Scratch assays. The toxicity profile of S. bryopteris extract ointment was evaluated on animals using acute toxicity and dermal toxicity tests. In vivo wound healing activity of S. bryopteris extract ointment (5% and 10%) was used to determine tensile strength in the incision wound healing model.

RESULTS

Results exhibited that the extract was safe up to 2000 mg/kg per oral dose and non-reactive while applied topically. In vitro results showed that S. bryopteris extract closed the wound gap created by 97.13% in 48 h. The clonogenic assay revealed that the surviving factor for HaCaT cells and MEF cells was 0.78 and 0.85 after treated with 10% concentrations of S. bryopteris. The tensile strength exhibited by S. bryopteris 5% and 10% groups was 395.4 g and 558.5 g in comparison to the control group.

CONCLUSION

Thus, S. bryopteris extract can be used as an alternative safe drug therapy against topical wounds.

Neuropharmacological and Antidiabetic Potential of Lannea coromandelica (Houtt.) Merr. Leaves Extract: An Experimental Analysis

The present study examines the neuropharmacological and antidiabetic properties of methanol leaves extract of Lannea coromandelica in animal models. This study is carried out by elevated plus-maze apparatus, motor coordination, thiopental sodium has an induction role in sleeping time, hole board, hole cross, open field, antidiabetic studies. Mice were treated doses of 100, 150, and 200 mg/kg body weight in elevated plus-maze apparatus and motor coordination; 100 and 200 mg/kg body weight in sleeping time, hole cross, hole board, and open field tests; and 200 and 400 mg/kg body weight in the antidiabetic activity test. Extraction specifies a significantly decreased time duration and sleeping time in a thiopental sodium-induced sleeping time test. The experimental extract decreased locomotor and exploratory behaviors of mice in the open-field and hole-cross tests compared to the effects of the control. Furthermore, the extract increased sleeping time with a dose-dependent onset of action. The hole-board test extract also demonstrated a reduced number of head dips. The findings showed that L. coromandelica has potential neuropharmacological effects. In addition, in alloxan-induced diabetic mice, leaves extract at 200 and 400 mg/kg body weight revealed significant antidiabetic properties and could be used to manage blood glucose levels with more research.

Non-Classical Effects of the cAMP Accumulation Activators In Vivo

Purpose: Wound-healing dipyridamole- and papaverine-based aerosols (D1/D2) as activators of the accumulation of cyclic adenosine monophosphate are promising drugs that can accelerate wound healing in wound processes of various origins. Methods: 128 rats were used in the study, including 38 in a pharmacological experiment on a model of stencil wounds and 90 in an experiment that studied the effect of spray on the number of CD34 cells in the blood of rats with chemically induced immunodeficiency. Immunodeficiency was caused by the fivefold administration of cyclophosphamide and prednisone. The expression level of CD34 was determined using flow cytofluorimeter. Results: Dipyridamole- and papaverine-based aerosols of two compositions (with and without ascorbic acid) have pronounced reparative properties, significantly accelerating epithelialization and healing of stencil wounds in rats. In terms of this type of action, they are somewhat superior to dexpanthenol. Dipyridamole- and papaverine-based aerosols have the ability to produce beneficial effect on the entire body's immune system by stimulating the division of pluripotent CD34 cells. The combined effect of papaverine and dipyridamole on tissues leads to selective stimulation of the division of pluripotent cells in the wound, and contributes to a six-fold acceleration of restoration of the animal's immune system after induced immunodeficiency. Conclusion: Topical application of D1/D2 aerosol samples on the skin of rats contributed to a statistically significant acceleration of regeneration processes. In terms of the appearance of granulations and epithelialization of wounds, D1/D2 aerosols were superior to dexpanthenol ointment.

Circulating Hypoxia Responsive microRNAs (HRMs) and Wound Healing Potentials of Green Tea in Diabetic and Nondiabetic Rat Models

Green tea (Camellia sinensis) has many biological activities and may promote diabetic wound healing by regulation of circulating hypoxia responsive microRNAs (HRMs) which triggers the wound repairing process in diabetic and nondiabetic wounds. Thus, in this study, the potential effects of green tea extract (GTE) on the expression of miRNAs; miR-424, miR-199a, miR-210, miR-21, and fibrogenitic markers; hydroxyproline (HPX), fibronectin (FN), and nitric oxide (NO) were evaluated in wounds of diabetic and nondiabetic rats. The animals were topically treated with vaseline, 0.6% GTE, and 5%w/w povidone iodine (standard control). HPX, FN, and NO levels and microRNAs, miR-424, miR-210, miR-199a, and miR-21, were estimated in wound tissues using colorimetric, immunoassay, and molecular PCR analysis. In vitro analysis was performed to estimate active constituents and their antioxidant activities in methanolic green teat extract (GTE). Wounds treated with green tea, a dose of 0.6, healed significantly earlier than those treated with standard vehicle and vaseline treated diabetic wounds. Higher expressions of HRMs, miR-199a, and miR-21, and lower expression of HRMs, miR-424 and miR-210, were significantly reported in tissues following treatment with green tea extract compared to standard control vehicle. The tissues also contained more collagen expressed as measures of HPX, FN, and NO and more angiogenesis, compared to wounds treated with standard control vehicle. Diabetic and nondiabetic wounds treated with green tea (0.6%) for three weeks had lesser scar width and greater re-epithelialization in shorter periods when compared to standard control vehicle. Expression of HRMs, miR-199a, miR-21, and HRMs and miR-424 and miR-210 correlated positively with HPX, fibronectin, NO, better scar formation, and tensile strength and negatively with diabetes. In addition to antidiabetic and antioxidant activities of green tea components, GTE showed angiogenesis promoting activity in diabetic wound healing. In conclusion, Camellia sinensis extracts in a dose of 0.6% significantly promote more collagen and fibronectin deposition with higher expression of NO, promoting angiogenesis process via molecular controlling of circulating hypoxia responsive microRNAs: miR-424, miR-210, miR-199a, and miR-21 in diabetic and nondiabetic wounds. Our results support a functional role of circulating hypoxia responsive microRNAs: miR-424, miR-210, miR-199a, and miR-21 as potential therapeutic targets in angiogenesis and vascular remodeling in diabetic wound healing.

Evaluation of astaxanthin incorporated collagen film developed from the outer skin waste of squid Doryteuthis singhalensis for wound healing and tissue regenerative applications

The present investigation was aimed to evaluate in vivo wound healing activity of astaxanthin incorporated collagen hydrogel film biomaterials extracted from the outer skin waste of squid Doryteuthis singhalensis, to releases antibiotic, delivering potentialities of excisional and incisional wound model in Wistar rats. These results suggested that the astaxanthin incorporated collagen film (ACF) and gentamicin incorporated collagen film (GCF) exhibited excellent wound healing activity (71%) in both full thickness excision and linear incision in rats. The in-vitro antioxidant abilities of extracted astaxanthin exhibited strongly significant 1,1‑diphenyl‑2‑picrylhydrazyl (DPPH) radical scavenging activity. In addition, tensile strength, epithelialization, hydroxyproline content and protein content in ACF and GCF treated groups were significantly increased. Histopathological assessment revealed an increase in collagen content, fibroblasts, granulation, thickness of scar formation, effective neovascularization and faster epithelialization within the short duration after the treatment of ACF and GCF compared to the control groups. The structure of prepared ACF and GCF biomaterials were characterized by SEM, EDS, and XRD. The in vivo biological study of the collagen-based film releases the antibiotic substance. The composite of collagen based biomaterials displays a promising biocompatibility through the dermal wound healing process as well as an evidence of biodegradability. Thus, the marine-derived biomaterials gave a substantial pledge for the development of biodegradable materials in drug delivery and soft tissue regeneration process.

Ameliorative effect of biofabricated ZnO nanoparticles of Trianthema portulacastrum Linn. on dermal wounds via removal of oxidative stress and inflammation

An impediment in the process of wound healing can be attributed to reactive oxygen species and inflammation. The curative efficacy of green synthesized Trianthema portulacastrum Linn. zinc oxide nanoparticles (ZnOTP) was investigated in the present study for evaluation of their wound healing potential in rodents. Total phenolic and flavonoid content of ZnOTP was determined, and antioxidant potential was evaluated by the DPPH method. In vitro anti-inflammatory activity of ZnOTP was evaluated by membrane stabilization and albumin denaturation, along with proteinase inhibitory assays. The synthesized ZnOTP were characterized by UV-Visible spectroscopy, Fourier transform infrared (FT-IR) studies, Field Emission Scanning Electron Microscopy (FESEM) and Energy Dispersive X-ray (EDX) studies. The wound healing potential of ZnOTP was monitored by excision and incision wound models. Analyses confirmed the formation of spherical nanoparticles of 10-20 nm size along with strong signals of zinc and oxygen atoms. Significant results (p < 0.05) of wound contraction rate, epithelialization and histopathology of the healed tissues of rats confirmed the promising wound healing property of ZnOTP. In addition, inflammatory markers, biochemical estimation such as the hydroxyproline content of granulation tissue, and the profile of antioxidant enzymes also supported the wound healing potential of ZnOTP. The present study advocated the attenuation of wounds via antioxidant and anti-inflammatory activities of a green synthesized nano-ointment.

Preliminary investigation for wound healing and anti-inflammatory effects of Bambusa vulgaris leaves in rats

BACKGROUND

Bambusa vulgaris (Family: Poaceae) used in Ayurveda for paralytic complaints, inflammatory disorders and externally to skin disorders. It has various medicinal uses with good nutritional composition and a rich source of vitamins, proteins, amino acid, beta-carotene and phenolic compounds.

OBJECTIVE

The present study was aimed to evaluate wound healing and anti-inflammatory potential of ethanol extract of B. vulgaris leaves in rats.

MATERIALS AND METHODS

The B. vulgaris leaves were evaluated for wound healing on incision and excision wound methods. Anti-inflammatory effect was evaluated by measurement of paw edema in carrageenan-induced inflammation in rats. Ethyl acetate (BVL-A) and aqueous (BVL-B) fractions from the ethanol extract of leaves were screened for wound healing effects by measuring tensile strength and biochemical parameters in incision wound method. The wound contraction area, antioxidant status and histopathological studies were done in excision wound method.

RESULTS

Tensile strength and hydroxyproline level of 5% w/w ointment of BVL-A and BVL-B treated groups were found significantly (P < 0.01) higher and comparable to the reference group. The histopathological study showed the proliferation of collagen, fibrous tissue, and capillaries with epidermal covering at the margin of the wound. The percent inhibition of paw edema was significantly decrease by increasing concentration of BVL-A and BVL-B fractions. In addition, it was found that B. vulgaris possesses antioxidant properties, by its ability to increase antioxidants level.

CONCLUSIONS

The results obtained in the present study were indicated that ethyl acetate fraction of B. vulgaris leaves inhibits paw edema and accelerates cutaneous wound healing.

Pharmacological Investigation of the Wound Healing Activity of Cestrum nocturnum (L.) Ointment in Wistar Albino Rats

Objectives. The present study was aimed at investigating the wound healing effect of ethanolic extract of Cestrum nocturnum (L.) leaves (EECN) using excision and incision wound model. Methods. Wistar albino rats were divided into five groups each consisting of six animals; group I (left untreated) considered as control, group II (ointment base treated) considered as negative control, group III treated with 5% (w/w) povidone iodine ointment (Intadine USP), which served as standard, group IV treated with EECN 2% (w/w) ointment, and group V treated with EECN 5% (w/w) ointment were considered as test groups. All the treatments were given once daily. The wound healing effect was assessed by percentage wound contraction, epithelialization period, and histoarchitecture studies in excision wound model while breaking strength and hydroxyproline content in the incision wound model. Result. Different concentration of EECN (2% and 5% w/w) ointment promoted the wound healing activity significantly in both the models studied. The high rate of wound contraction (P < 0.001), decrease in the period for epithelialization (P < 0.01), high skin breaking strength (P < 0.001), and elevated hydroxyproline content were observed in animal treated with EECN ointments when compared to the control and negative control group of animals. Histopathological studies of the EECN ointments treated groups also revealed the effectiveness in improved wound healing. Conclusions. Ethanolic extract of Cestrum nocturnum (EECN) leaves possesses a concentration dependent wound healing effect.

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.

Nitric oxide synthase inhibitors appear to improve wound healing in endotoxemic rats: An investigator-blinded, controlled, experimental study

BACKGROUND

Although inflammation is a normal part of wound healing, if the inflammatory response is excessive the repair process might be prolonged. Nitric oxide (NO) has been implicated in healing inflammation and wounds.

OBJECTIVE

Endotoxins and cytokines associated with sepsis induce NO synthesis in the tissues. This study used tensile strength and tissue hydroxyproline levels as proxies for wound healing to determine whether wound healing in the presence of endotoxemia is improved when NO synthase is inhibited by N-nitro-l-arginine methyl ester (L-NAME) or N (5)-(1-Imino-methyl)-l-ornithine (L-NIO).

METHODS

In this investigator-blinded, controlled, experimental study, male Wistar albino rats (275-300 g) were divided into 4 groups. The first group received an intraperitoneal (IP) injection of Escherichia coli endotoxin 10 mg/kg and an SC injection of 0.9% sodium cloride (NaCl). The second group received IP E coli 10 mg/kg and SC L-NAME 2 mg/kg. The third group received IP E coli 10 mg/kg and L-NIO 10 mg/kg. The control group was administered an IP and an SC injection of 0.9% NaCl. Each group received both injections at 24 and 16 hours before surgery. All rats underwent a 3-cm dorsal midline incision, which was subsequently closed. Five days after surgery, all rats were euthanized and skin from the healing wound was excised. Hydroxyproline levels and tensile strength were then measured.

RESULTS

Forty-four male rats (mean age, 16 weeks; mean [SD] weight, 284 [16] g) were included in the study. Each of the groups receiving endotoxin (endotoxin, L-NAME, and L-NIO groups) had 12 rats; the control group consisted of 8 rats. All the groups that received endotoxin showed significant declines in hydroxyproline levels versus controls (P < 0.001, P = 0.001, and P = 0.002, respectively). Compared with the control group, the endotoxin-only group had a significant reduction in both mean (SD) hydroxyproline levels and mean (SD) wound tensile strength (298.27 [17.66] vs 175.82 [18.73] g/cm2 and 7.16 [0.51] vs 4.01 [0.29] μg/mg wet tissue; both, P < 0.001). Compared with the endotoxin- only group, rats that received L-NIO had significantly greater mean (SD) hydroxyproline levels and mean (SD) wound tensile strength (6.44 [0.34] vs 4.01 [0.29] μg/mg wet tissue and 280.12 [14.38] vs 175.82 [18.73] g/cm(2); both, P < 0.001). Wound tensile strength in the L-NIO group was not significantly different from that in the control group. A significant difference was observed between the L-NIO and L-NAME groups in wound tensile strength (280.12 [14.38] vs 241.38 [20.69] g/cm(2); P = 0.001), but not in tissue hydroxyproline levels.

CONCLUSION

Inhibition of NO synthesis might improve wound tensile strength, which suggests a possible role for NO inhibitors in improved wound healing in the presence of endotoxemia.

Hexane extract of the seeds of Byrsonima crassifolia accelerates wound healing in streptozotocin-induced diabetic rats

OBJETIVE

To study the effect of seeds of Byrsonima crassifolia in diabetic wound healing.

METHODS

Wound healing potential of hexane extract in the form of simple ointment for the treatment of dermal wounds was studied in streptozotocin-induced diabetic rats on excision wound, incision wound and dead space wound. Various parameters such as epithelization period, scar area, tensile strength, hydroxyproline, total protein, DNA, hexosamine, uronic acid, antioxidant enzymes including superoxide dismutase (SOD) and catalase activity (CAT) were used to evaluate the effect of B. crassifolia on wound healing.

RESULTS

Hexane extract in form topical accelerates the wound healing process by decreasing the surface area of the wound with a significant increase in the rate of wound contraction and tensile strength; increase granulation tissue dry weight, hydroxyproline, total protein, DNA and SOD and CAT when compared with diabetic control.

CONCLUSION

B. crassifolia was effective in promoting diabetic wound healing in rats through the processes of tissue regeneration.

Evaluation of Antimicrobial and Wound Healing Potential of Justicia flava and Lannea welwitschii

Microbial infections of various types of wounds are a challenge to the treatment of wounds and wound healing. The aim of the study is to determine the antimicrobial, antioxidant, and in vivo wound healing properties of methanol leaf extracts of Justicia flava and Lannea welwitschii. The antimicrobial activity was investigated using agar well diffusion and microdilution methods. The free radical scavenging activity of the methanol leaf extracts was performed using 1,1-diphenyl-2-picryl-hydrazyl (DPPH). The rate of wound contraction was determined using excision model. The test organisms used were Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 4853, Bacillus subtilis NTCC 10073, Staphylococcus aureus ATCC 25923, and clinical strains of Candida albicans. The MICs of methanol leaf extract of J. flava against test organisms were E. coli (7.5 mg/mL); P. aeruginosa (7.5 mg/mL); S. aureus (5 mg/mL); B. subtilis (7.5 mg/mL); and C. albicans (5 mg/mL). The MICs of methanol leaf extract of L. welwitschii against test organisms were E. coli (5 mg/mL); P. aeruginosa (10 mg/mL); S. aureus (5 mg/mL); B. subtilis (2.5 mg/mL); and C. albicans (2.5 mg/mL). The MBC/MFC of the extract was between 10 and 50 mg/mL. The IC50 of the reference antioxidant, α -tocopherol, was 1.5  μ g/mL and the methanol leaf extracts of J. flava and L. welwitschii had IC50 of 65.3  μ g/mL and 81.8  μ g/mL, respectively. The methanol leaf extracts of J. flava and L. welwitschii gave a significant reduction in wound size as compared to the untreated. The rates of wound closure after the application of the extracts (7.5% w/w) were compared to the untreated wounds. On the 9th day, J. flava extract had a percentage wound closure of 99% (P < 0.01) and that of L. welwitschii exhibited wound closure of 95% (P < 0.05) on the 13th day compared to the untreated wounds. The two extracts significantly (P < 0.01) increased the tensile strength of wounds compared to the untreated wounds. The extracts treated wound tissues showed improved angiogenesis, collagenation, and reepithelialization compared to the untreated wound tissues. The preliminary phytochemical screening of J. flava and L. welwitschii leaf extracts revealed the presence of tannins, alkaloids, flavonoids, and glycosides. The above results indicate that methanol leaf extracts of J. flava and L. welwitschii possess antimicrobial and wound healing properties which may justify the traditional uses of J. flava and L. welwitschii in the treatment of wounds and infections.

Wound healing activity of Sida cordifolia Linn. in rats

INTRODUCTION

The present study provides a scientific evaluation for the wound healing potential of ethanolic (EtOH) extract of Sida cordifolia Linn. (SCL) plant.

MATERIALS AND METHODS

Excision, incision and burn wounds were inflicted upon three groups of six rats each. Group I was assigned as control (ointment base). Group II was treated with 10% EtOH extract ointment. Group III was treated with standard silver sulfadiazine (0.01%) cream. The parameters observed were percentage of wound contraction, epithelialization period, hydroxyproline content, tensile strength including histopathological studies.

RESULT

It was noted that the effect produced by the ethanolic extract of SCL ointment showed significant (P < 0.01) healing in all wound models when compared with the control group. All parameters such as wound contraction, epithelialization period, hydroxyproline content, tensile strength and histopathological studies showed significant (P < 0.01) changes when compared with the control.

CONCLUSION

The ethanolic extract ointment of SCL effectively stimulates wound contraction; increases tensile strength of excision, incision and burn wounds.

Wound healing activity of latex of Euphorbia caducifolia

ETHNOPHARMACOLOGICAL RELEVANCE

[corrected] Euphorbia caducifolia is a Euphorbiaceae species native to Thar Desert of India, where latex of E. caducifolia (ECL) is used by the local inhabitants for treatment of bleeding wound, cutaneous eruption and other skin diseases. Looking to the medicinal importance of the plant, it was considered worthwhile to scientifically evaluate the ECL for the wound healing activity.

MATERIAL AND METHODS

In vitro methods, clotting of platelet free plasma and angiogenesis in chick chorioallantoic membrane (CCM) were used for studying effect of ECL on clotting and angiogenesis. Excision and incision wounds model were used to study effect of ECL on wound contraction, tensile strength and hydroxyproline and DNA content.

RESULTS

ECL treatment stimulates the blood vessel formation in CCM, at the all dose levels. 56.77, 74.48 and 78.09% increase in area of angiogenesis was observed in ECL 2.5, 5.0 and 10mg/ml treated groups respectively. The excised skin of ECL 5.0 and 10mg/ml treated animals found to have higher content of hydroxyproline and DNA, when compared with control group. An acceleration of the wound closure was observed with an enhanced number of fibroblasts and collagen content in ECL treated mice.

CONCLUSION

Result of in vitro and in vivo experiments indicate that ECL exerts significant wound healing activity, demonstrating its relevant therapeutic potential.

Investigation of wound healing activity of methanolic extract of stem bark of Mimusops elengi Linn

The present study was aimed to evaluate the wound healing activity of extract of bark part of Mimusops elengi. It is well-known plant in Indian traditional medicines. On the basis of traditional use and literature references, this plant was selected for wound healing potential. A methanolic extract of bark parts of Mimusops elengi was examined for wound healing activity in the form of ointment in three types of wound models on mice: the excision, the incision and dead space wound model. The extract ointments showed considerable response in all the above said wound models as comparable to those of a standard drug Betadine ointment in terms of wound contracting ability, wound closure time, tensile strength and dry granuloma weight. Histological analysis was also consistent with the proposal that Mimusops elengi bark extract exhibits significant wound healing.

Wound healing potential of methanolic extract of Trichosanthes dioica Roxb (fruits) in rats

AIM OF THE STUDY

The present study provides a scientific evaluation for the wound healing potential of methanolic (MeOH) extract of TDR fruits.

MATERIALS AND METHODS

Excision and incision wounds were inflicted upon three groups of six rats each. Group I was assigned as control (ointment base), Group II was treated with standard silver sulfadiazine (0.01%) cream. Group III was treated with 5% MeOH extract ointment. The parameters observed were percentage of wound contraction, epithelialization period, hydroxyproline content, tensile strength including histopathological studies.

RESULTS

It was noted that the effect produced by the extract ointment showed significant (P<0.01) healing in both the wound models when compared with control group. All parameters such as wound contraction, epithelialization period, hydroxyproline content, tensile strength and histopathological studies showed significant changes when compared to control.

CONCLUSION

The result shows that TDR extract ointment demonstrates wound healing potential in both excision and incision models.

Influence of hydroxyethyl starch on healing of colonic anastomosis in a rat model of peritonitis

BACKGROUND

This study was designed to evaluate the role of different intravascular volume replacement regimens of HES 130/0.4 on wound healing process in left colonic anastomoses in the presence of intra-abdominal sepsis induced by murine model of cecal ligation and puncture (CLP).

METHODS

The left colonic anastomosis was performed in 40 rats that were divided into five groups (n = 8/group): saline controls (30 ml/kg); CLP plus saline (30 ml/kg); CLP plus HES (7.5, 15, or 30 ml/kg, respectively). Saline or HES was treated before the construction of left colonic anastomosis and on a regular daily basis. Anastomotic bursting pressures were measured in vivo on day 5. Tissue samples were obtained for analyses of hydroxyproline (HP) contents, myeloperoxidase (MPO) activity, malondialdehyde (MDA), reduced glutathione (GSH) levels, and nuclear factor-kappa B (NF-kappa B) activation. The plasma levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 were also measured.

RESULTS

Intra-abdominal sepsis led to significant decreases in colonic anastomotic bursting pressures, and perianastomotic tissue HP contents and GSH levels, along with increases in perianastomotic tissue MPO activity, MDA levels and NF-kappa B activation and plasma levels of TNF-alpha and IL-6. After treated with HES, these provoked perianastomotic tissue MPO activity, MDA levels, NF-kappa B activation, and plasma levels of TNF-alpha and IL-6 were suppressed and GSH levels were restored, especially in 15 ml/kg HES group. Without obvious influence on systemic nutritional condition, HES 15 ml/kg but not HES 7.5 ml/kg significantly increased anastomotic bursting pressures, and perianastomotic tissue HP contents. However, HES 30 ml/kg even led to adverse effects on anastomotic bursting pressures.

CONCLUSIONS

This study showed that moderate doses (15 ml/kg) of HES 130/0.4 administration significantly prevented this intraperitoneal sepsis-induced impaired anastomotic healing of the left colon. It also suggested the possibility of poorer anastomotic healing receiving HES at higher doses (30 ml/kg). Clearly, HES 130/0.4 now should not be recommended to use at a high doses postoperatively in sepsis.

Hydroxyethyl starch 130/0.4 augments healing of colonic anastomosis in a rat model of peritonitis

BACKGROUND

This study was designed to investigate the role of hydroxyethyl starch (HES) 130/0.4 on the wound healing process in left colonic anastomoses in the presence of intra-abdominal sepsis.

METHODS

The left colonic anastomosis was performed in 40 rats that were divided into 4 groups: (1) group SHAM, laparatomy plus cecal mobilization (n = 10); (2) group SHAM + HES, HES130/.4-treated controls (n = 10); and (3) group CLP, cecal ligation and puncture (n = 10); (4) group CLP + HES, CLP plus HES130/.4 (n = 10). HES130/.4 was administrated before the construction of colonic anastomosis, 15 mL/kg/24 hours and daily for 4 postoperative days. Anastomotic bursting pressures (ABPs) were measured in vivo on day 5. Tissue samples were obtained for analyses of hydroxyproline (HP) contents, myeloperoxidase (MPO) activity, malondialdehyde (MDA), reduced glutathione (GSH) levels, and nuclear factor-kappaB (NF-kappaB) activation. The plasma levels of tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, d-dimer, and protein C (PC) were also measured. Anastomotic granulation tissues were fixed for transmission electron microscopic (TEM) analyses.

RESULTS

Intra-abdominal sepsis led to significant decreases in colonic anastomotic bursting pressures, perianastomotic tissue HP contents, GSH levels, and plasma levels of PC, along with increases in perianastomotic tissue MPO activity, MDA levels, NF-kappaB activation, and plasma levels of TNF-alpha, IL-6, and d-dimer. However, HES130/.4 treatment significantly inhibited all these responses. TEM analyses revealed that there was a trend toward a higher density of fibroblast distribution and a higher rate of fibroblast activation in the SHAM- and HES 130/0.4-treated animals, compared with the CLP group.

CONCLUSIONS

This study showed that moderate doses (15 mL/kg) of HES 130/0.4 administration significantly prevented this intraperitoneal sepsis-induced impaired anastomotic healing of the left colon. This beneficial effect of HES 130/0.4 can be mainly attributed to its anti-inflammatory and antioxidant properties and beneficial effects of modulating endothelial-associated coagulopathy.

Wound healing potential of Tephrosia purpurea (Linn.) Pers. in rats

Tephrosia purpurea is a well-known herb for its hepatoprotective, anticancer, antiulcer, antibacterial and in healing bleeding piles, etc. The present study was aimed for wound healing potential of ethanolic extract of Tephrosia purpurea (aerial part) in the form of simple ointment using three types of wound models in rats as incision wound, excision wound and dead space wound. The results were comparable to standard drug Fluticasone propionate ointment, in terms of wound contraction, tensile strength, histopathological and biochemical parameters such as hydroxyproline content, protein level, etc. Histopathological study showed significant (P<0.05) increase in fibroblast cells, collagen fibres and blood vessels formation. All parameters were observed significant (P<0.05) in comparison to control group.

The effect of colloidal fluid replacement on wound healing in an experimental sublethal hemorrhagic shock model

OBJECTIVE

The aim of the study was to evaluate the effects of different resuscitation solutions on wound healing in an animal model of sublethal hemorrhagic shock.

METHODS

Sublethal hemorrhagic shock was established by blood withdrawal until the mean arterial pressure fell to 40 mmHg within 15 min. Animals were resuscitated with four different solutions: group I (n=19) 0.9% NaCl, group II (n=20) 10% dextran 40, group III (n=20) 6% hydroxyethyl starch, group IV (n=18) 4% modified fluid gelatin. Following inhalation anesthesia, a full thickness skin incision of 2 cm in length was made on the abdominal wall and sutured primarily. The incision wound on the abdominal wall was excised on the fifth day. The breaking strength of the incision and hydroxyproline content of dry tissue were evaluated.

RESULTS

Differences in breaking strength values were observed between groups I-III and I-IV (P<0.05). Hydroxyproline values were significantly lower in group IV (58.47 microg/ml) and group II (69.17 microg/ml) (P<0.05). The gelatin-resuscitated group had lower breaking strength and hydroxyproline values than the other groups.

CONCLUSION

It can be concluded that resuscitation with modified fluid gelatin may have detrimental effects on wound healing in an experimental model of sublethal hemorrhagic shock.

Platelet aggregability and the occurrence of anastomotic leakage after esophageal reconstruction

In 21 patients who had undergone resection and reconstruction for esophageal carcinoma, the postoperative platelet aggregability was measured and the correlation between the occurrence of anastomotic leakage and platelet aggregability was investigated. There was no statistical difference in the clinical features of the patients between those with (n = 5) and without (n = 16) anastomotic leakage. Platelet aggregability was measured by the turbidimetric method from blood samples taken preoperatively, and at 1, 3, and 7 postoperative days (POD). The average values of platelet aggregability in patients without anastomotic leakage were 81.2, 70.4, 80.1, and 81.8%, while those with leakage were 81.3, 47.6, 52.3, 70.6% preoperatively, and 1, 3, and 7 POD, respectively. Thus, platelet aggregability significantly decreased in patients with anastomotic leakage on the first postoperative day (p < .05), and then gradually recovered postoperatively as time passed. Therefore, the measurement of platelet aggregability is considered to be one of the parameters predicting the occurrence of anastomotic leakage, and a prevention in the decrease of platelet aggregability as well as its activation could become a treatment for preventing anastomotic leakage.