1
|
Cordiano R, Gammeri L, Di Salvo E, Gangemi S, Minciullo PL. Pomegranate ( Punica granatum L.) Extract Effects on Inflammaging. Molecules 2024; 29:4174. [PMID: 39275022 PMCID: PMC11396831 DOI: 10.3390/molecules29174174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 08/28/2024] [Accepted: 08/29/2024] [Indexed: 09/16/2024] Open
Abstract
Pomegranate is a notable source of nutrients, containing a considerable proportion of organic acids, polysaccharides, vitamins, fatty acids, and polyphenols such as flavonoids, phenolic acids, and tannins. It is also rich in nutritionally important minerals and chemical elements such as K, P, Na, Ca, Mg, and N. The presence of several bioactive compounds and metabolites in pomegranate has led to its incorporation into the functional food category, where it is used for its numerous therapeutic properties. Pomegranate's bioactive compounds have shown antioxidant, anti-inflammatory, and anticancer effects. Aging is a process characterized by the chronic accumulation of damages, progressively compromising cells, tissues, and organs over time. Inflammaging is a chronic, subclinical, low-grade inflammation that occurs during the aging process and is linked to many age-related diseases. This review aims to summarize and discuss the evidence of the benefits of pomegranate extract and its compounds to slow the aging processes by intervening in the mechanisms underlying inflammaging. These studies mainly concern neurodegenerative and skin diseases, while studies in other fields of application need to be more practical. Furthermore, no human studies have demonstrated the anti-inflammaging effects of pomegranate. In the future, supplementation with pomegranate extracts, polyphenols, or urolithins could represent a valuable low-risk complementary therapy for patients with difficult-to-manage diseases, as well as a valid therapeutic alternative for the topical or systemic treatment of skin pathologies.
Collapse
Affiliation(s)
- Raffaele Cordiano
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Luca Gammeri
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Eleonora Di Salvo
- Department of Biomedical and Dental Science and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
| | - Sebastiano Gangemi
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Paola Lucia Minciullo
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| |
Collapse
|
2
|
do Nascimento MF, de Oliveira CR, Cardoso JC, Bordignon NCT, Gondak R, Severino P, Souto EB, de Albuquerque Júnior RLC. UV-polymerizable methacrylated gelatin (GelMA)-based hydrogel containing tannic acids for wound healing. Drug Deliv Transl Res 2023; 13:3223-3238. [PMID: 37474880 PMCID: PMC10624738 DOI: 10.1007/s13346-023-01383-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/22/2023]
Abstract
Gelatin-based photopolymerizable methacrylate hydrogel (GelMA) is a promising biomaterial for in situ drug delivery, while aqueous extract of Punica granatum (AEPG) peel fruit rich in gallic acid and ellagic acid is used to improve wound healing. The aim of this study was to develop and analyze the healing properties of GelMA containing AEPG, gallic acid, or ellagic acid in a rodent model. GelMA hydrogels containing 5% AEPG (GelMA-PG), 1.6% gallic acid (GelMA-GA), or 2.1% ellagic acid (GelMA-EA) were produced and their mechanical properties, enzymatic degradation, and thermogravimetric profile determined. Wound closure rates, healing histological grading, and immunohistochemical counts of myofibroblasts were assessed over time. The swelling of hydrogels varied between 50 and 90%, and GelMA exhibited a higher swelling than the other groups. The GPG samples showed higher compression and Young's moduli than GelMA, GGA, and GAE. All samples degraded around 95% in 48 h. GPG and GGA significantly accelerated wound closure, improved collagenization, increased histological grading, and hastened myofibroblast differentiation in comparison to the control, GelMA, and GEA. GelMA containing AEPG (GPG) improved wound healing, and although gallic acid is the major responsible for such biological activity, a potential synergic effect played by other polyphenols present in the extract is evident.
Collapse
Affiliation(s)
| | - Clauberto R de Oliveira
- Biotechnological Postgraduate Program-RENORBIO, Federal University of Sergipe, São Cristóvão, Sergipe, 49100-000, Brazil
| | - Juliana C Cardoso
- Postgraduate Program in Health and Environment, Tiradentes University, Aracaju, Sergipe, 49032-490, Brazil
| | - Natalia C T Bordignon
- Department of Dentistry, Post-Graduating Program in Dentistry, Federal University of Santa Catarina, Florianópolis, 88040-370, Brazil
| | - Rogério Gondak
- Department of Dentistry, Post-Graduating Program in Dentistry, Federal University of Santa Catarina, Florianópolis, 88040-370, Brazil
- Department of Pathology, Health Sciences Center, Federal University of Santa Catarina, R. Delfino Conti, S/N, Florianópolis, Santa Catarina, 88040-370, Brazil
| | - Patrícia Severino
- Post-Graduating Program in Industrial Biotechnology, University of Tiradentes, Av. Murilo Dantas, 300, Aracaju, 49010-390, Brazil
| | - Eliana B Souto
- UCIBIO-Applied Molecular Biosciences Unit, MEDTECH, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal.
- Associate Laboratory i4HB, Department of Pharmaceutical Technology, Faculty of Pharmacy, Institute for Health and Bioeconomy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal.
| | - Ricardo L C de Albuquerque Júnior
- Department of Dentistry, Post-Graduating Program in Dentistry, Federal University of Santa Catarina, Florianópolis, 88040-370, Brazil.
- Department of Pathology, Health Sciences Center, Federal University of Santa Catarina, R. Delfino Conti, S/N, Florianópolis, Santa Catarina, 88040-370, Brazil.
| |
Collapse
|
3
|
Atsü Md AN, Tosuner Md Z, Bilgiç Md T. Evaluation of the Effect of Pomegranate Seed Oil on Healing in a Rat Wound Model With Antioxidant, Vascular, and Histopathological Parameters. INT J LOW EXTR WOUND 2023; 22:661-671. [PMID: 34463139 DOI: 10.1177/15347346211040593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study aimed to evaluate the efficiency of pomegranate (Punica granatum) seed oil in wound healing in excised rats. Sixteen female young Wistar Albino Rats weighing approximately 300 to 320 g were randomly divided into 2 groups as the treatment (=pomegranate seed oil group) and control groups in this experiment. Six different wounds 1 cm apart from the midline and each other were formed with a 6 mm punch biopsy instrument. Three wounds were left open (open wound group) whereas 3 wounds were sutured with 4/0 vicryl (closed wound group). Punica granatum seed oil treatment was administered topically to the treatment group, both to open and closed wounds, once a day for 14 days. Parameters for healing were evaluated. Histopathologic examination was performed for the investigation of inflammation, neovascularization, granulation, and fibroblast generation in addition to serologic (enzyme-linked immunosorbent assay) evaluation of rat malondialchehyche, rat glutathione peroxidase, and rat superoxide dismutase. PeriScan PIM 3 System Laser Doppler Blood Perfusion Imager was used for the calculation of blood perfusion. There was a statistically significant difference between inflammation and neovascularization levels and group type on the 14th day in open wounds(P < .05). On the 21st day, the granulation tissue level in the closed wound group was found to be higher in the pomegranate group (P = 0.000).The results showed that PSE oil is partially effective, although it is not effective in every parameter examined, in the treatment of excised wounds in rats and may be suitable for clinical treatment in humans but large controlled studies are needed.
Collapse
Affiliation(s)
- A Nilhan Atsü Md
- Faculty of Health Sciences, Istanbul Kent University, Istanbul, Turkey
| | - Zeynep Tosuner Md
- Department of Pathology, Acıbadem University, Atakent Hospital, İstanbul, Turkey
| | | |
Collapse
|
4
|
Niknam S, Tofighi Z, Faramarzi MA, Abdollahifar MA, Sajadi E, Dinarvand R, Toliyat T. Polyherbal combination for wound healing: Matricaria chamomilla L. and Punica granatum L. Daru 2021; 29:133-145. [PMID: 33966255 PMCID: PMC8149548 DOI: 10.1007/s40199-021-00392-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 03/17/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Punica granatum L. (pomegranate) with astringent activities and Matricaria chamomilla L. (chamomile) with anti-inflammatory and antioxidant properties are natural remedies used for various skin disorders, including wound healing. OBJECTIVES This study was conducted to evaluate the individual and combined wound healing activity of the methanol extracts of pomegranate and chamomile flowers. METHODS After preparing the menthol fraction of pomegranate and chamomile flowers, the content of total phenols, total tannins, and total flavonoids of fractions was measured. For standardization of pomegranate and chamomile fractions, Gallic acid and apigenin-7-O-glucoside contents of them were determined using high-performance liquid chromatography (HPLC). Moreover, their antioxidant activities were examined using DPPH and FRAP tests. The antimicrobial assay was performed against Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa. Three different concentrations of methanol fraction of each plant and one combination dose of fractions were investigated for their wound healing activities in an excision wound model on the rats' dorsum. Finally, histopathological studies were done at the end of the experiment. RESULTS Phytochemical examinations showed high amounts of phenolic compounds in pomegranate flowers, while chamomile flower fractions contained a high amount of total flavonoids. Both fractions, especially pomegranate, had potent antioxidant activity. The best results for wound closure were observed 7 days after wound induction. All treated groups exhibited superior wound contraction compared to their placebo at all measurement times. The combined form of pomegranate and chamomile had better wound healing properties compared to a single therapy, especially on time earlier to wound induction. CONCLUSION This study represented high antioxidant and wound healing activities for methanol fraction of pomegranate and chamomile flowers, which could be related to their high content of phytochemicals. In comparison with single herb treatment, the combined form of these two fractions in lower concentrations accelerated wound closure.
Collapse
Affiliation(s)
- Somayeh Niknam
- Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Tofighi
- Department of Pharmacology and Medical Plants Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Faramarzi
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy and Biotechnology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Abdollahifar
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ensieh Sajadi
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rassoul Dinarvand
- Nanotechnology Research Centre, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Toliyat
- Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
5
|
Fana SE, Ahmadpour F, Rasouli HR, Tehrani SS, Maniati M. The effects of natural compounds on wound healing in Iranian traditional medicine: A comprehensive review. Complement Ther Clin Pract 2020; 42:101275. [PMID: 33429123 DOI: 10.1016/j.ctcp.2020.101275] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/18/2020] [Indexed: 11/30/2022]
Abstract
Wounds are physical and anatomical disruption in healthy skin and represent an important healthcare concern around the world. Wound healing is a complex and dynamic cascade of cellular and molecular interactions which include four main phases: hemostasis, inflammatory, proliferative, and remodeling. Therefore, some pharmacological activities such as anti-inflammatory, antioxidant, and antimicrobial activities can play a key role in the process of wound healing. Iranian Traditional Medicine (ITM) has a rich background of practice and a wealth of ancient medicine scientists from the Old Persian days until today. This paper presents and characterizes pure data from original references of ITM about wound remedies and verifies their function by reviewing articles from three databases (Google Scholar, PubMed, and Scopus), which could be an interesting and comprehensive resource for future researchers interested in traditional medicine (TM) generally and in ITM in particular. Selected natural compounds from the references were divided into 5 groups, including herbs, herbal products, animal products, minerals, and animals. In total, 23 natural compounds with regard to the current state of knowledge and ITM were introduced and verified. The present review will provide better insights into ITM and its extensive experience in topics such as wound healing.
Collapse
Affiliation(s)
- Saeed Ebrahimi Fana
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Fathollah Ahmadpour
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Hamid Reza Rasouli
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Sadra Samavarchi Tehrani
- Department of Clinical Biochemistry, Tehran University of Medical Sciences, Tehran, Iran; Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Maniati
- Department of English, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
6
|
Hassanpour SE, Farnoush N, Karami MY, Makarem A. The effect of silicone gel versus contractubex gel on the upper-extremity postsurgical scars: A randomized, double-blinded, controlled trial. Med J Islam Repub Iran 2020; 34:146. [PMID: 33437742 PMCID: PMC7787045 DOI: 10.34171/mjiri.34.146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Wound healing is a process that has three overlapping inflammatory, proliferative, and reconstruction phases. Silicone gel and Contractubex (onion extract gel) are two main topical agents used for the prevention and treatment of hypertrophic scars. This clinical trial study aimed to evaluate the efficacy and safety of onion extract and silicone gel on hypertrophic scars of the upper extremity and compare it to non-treated patients.
Methods: This randomized, double-blind, parallel, clinical trial was done on 120 male patients who had undergone upper extremity sharp injury repair. Patients were assigned to three groups, i.e., Silicone gel (Kelo-cortTM; WA, USA) (group 1; 40 patients), Onion extract (ContractubexTM, Merz Pharma, Frankfurt, Germany) gel (group 2; 40 patients), and No Intervention (group 3; 40 patients), using drawing sealed envelopes and a computer-based table of randomization. Data were recorded using the Vancouver scale in each visit by two surgeons who were blinded to the study groups. IBM SPSS Statistics for Windows, Version 22.0. (Armonk, NY: IBM Corp). Data were compared using the ANOVA test. A P-value of less than 0.05 was considered statistically significant.
Results: Vascularity (p=0.200), pliability (p=0.058), pigmentation (p=0.701), and height (p=0.438) as subjective scar parameters were approximately similar in post-upper extremity sharp injury wound hypertrophic scar among the three groups.
Conclusion: Vascularity, pliability, pigmentation and height, as subjective scar parameters, were not statistically different in post-upper extremity sharp injury wound hypertrophic scar among the groups. Even though onion extract gel and Silicone gel show preventive effects in the literature, especially in burns wounds, further studies are recommended to be conducted to prove the topical effects of above-mentioned gels in patients.
Collapse
Affiliation(s)
- Seyed Esmail Hassanpour
- Department of Plastic Surgery,15 Khordad Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazila Farnoush
- Department of Plastic Surgery,15 Khordad Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Yasin Karami
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Makarem
- Department of Urology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
7
|
Hancioğlu S, Demirel BD, Biçakci Ü, Gün S, Aritürk E, Aritürk N. Histopathological and mechanical effects of Ankaferd Blood Stopper® on wound healing in rats: an experimental model. Turk J Med Sci 2020; 50:1428-1433. [PMID: 32490638 PMCID: PMC7491291 DOI: 10.3906/sag-2004-177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/19/2020] [Indexed: 12/02/2022] Open
Abstract
Background/aim To evaluate the histopathological and mechanical effects of Ankaferd Blood Stopper (ABS) application on wound healing. Materials and methods A total of 24 Wistar albino rats were randomly divided into three equal groups. In each group, a 3 cm-long midline vertical skin incision was performed in the back of the rats. In Group 1, the incision was sutured primarily. In Group 2, incision was left to secondary healing. In Group 3, ABS was applied to the incision. On the 10th day, burst pressure width was measured, and rats were sacrificed. The tissue samples were examined histopathologically. Statistical analysis was conducted with IBM SPSS program. P < 0.05 was considered significant. Results The mean burst pressure widths of wound separation were 13.66 ± 0.457, 7.18 ± 2.599, and 13.66 ± 1.11 mm for Groups 1–3, respectively. The difference in burst pressure width between Groups 1 and 3 was not significant (P > 0.05) but was significant between Groups 2 and 3 (P = 0.000). The vascular proliferation median values were 1, 2, and 2, for Groups 1–3, respectively. Although the difference was significant between Groups 1 and 2 in terms of vascular proliferation score (P = 0.047), no significant difference was observed between Group 3 and others. No statistically significant difference was observed among the groups in terms of collagen score, mononuclear cell infiltration, and polymorphonuclear cell proliferation (P > 0.05). The median values of fibroblast proliferation score were 1, 2, and 3, in Groups 1–3, respectively. Fibroblast proliferation score significantly differed between Groups 1 and 3 (P = 0.003). Conclusion ABS application results in a clean wound healing that is as strong as primary repair. However, additional studies are required to evaluate the late results of increased fibroblastic activity in the early period of ABS application alone.
Collapse
Affiliation(s)
- Sertaç Hancioğlu
- Department of Pediatric Surgery, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Berat Dilek Demirel
- Department of Pediatric Surgery, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Ünal Biçakci
- Department of Pediatric Surgery, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Seda Gün
- Department of Pathology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Ender Aritürk
- Department of Pediatric Surgery, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Nurşen Aritürk
- Department of Ophthalmology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| |
Collapse
|
8
|
Karami MY, Mansournia N, Bagherian N, Makarem A, MoeinVaziri N, Borna S, Pourdavood AH, Shamohammadi I. Effects of Azelnidipine-Carboxymethylcellulose Gel on Healing of Full-Thickness Skin Wounds in Streptozotocin Induced Diabetic Rats. VETERINARY MEDICINE-RESEARCH AND REPORTS 2020; 10:215-222. [PMID: 31908995 PMCID: PMC6925554 DOI: 10.2147/vmrr.s224514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/05/2019] [Indexed: 11/23/2022]
Abstract
Objective To evaluate the effects of azelnidipine-carboxyl methyl cellulose (AZL-CMC) gel and carboxyl methyl cellulose 2% gel (CMC) on the healing of full-thickness skin wounds of diabetic rats. Methods Fifteen Sprague Dawley male rats were studied. The rats were divided into three groups: AZL-CMC gel-treated, CMC 2% gel-treated, and control group. Wounds were assessed by wound area measurement every 3 days and histopathology samples were collected at 4, 7 and 12 days post wounding to evaluate the healing process using stereological study. Mann–Whitney U-test repeated measurement and non-parametric one-way analysis of variance (ANOVA) were used to analyze the data using SPSS, version 18. Results Numerical density of the fibroblasts of the AZL-CMC gel treated group was 59.17±2.69 (×104/mm3) and higher than the control 22.64±1.34 (×104/mm3) and CMC 2%-treated groups 40.80±5.27 (×104/mm3), respectively, P<0.001. The volume density of the collagen bundles and LV of the vessels were 83.1±4.46 and 42.16±5.78, respectively, in the AZL-CMC treated group, and higher compared to the control (53.96±5.07, 9.9±2.49) and the CMC 2%-treated (65.88±2.13, 18.1±2.20) groups (P <0.001). Conclusion The healing of AZL-CMC gel-treated wound was better than the control wounds, grossly. Wound healing processes and wound closure in the intervention group began sooner and was completed more quickly. The quantitative and qualitative parameters showed the significant wound healing effect of the AZL-CMC gel-treated group.
Collapse
Affiliation(s)
- Mohammad Yasin Karami
- Metabolic Disease Research Center, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.,Breast Disease Research Center, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Mansournia
- Metabolic Disease Research Center, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Neda Bagherian
- Department of Pediatrics, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Makarem
- Department of Urology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader MoeinVaziri
- Department of Surgery, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sahar Borna
- Student Research Committee, Faculty of Medicine, Sari University of Medical Sciences, Sari, Iran
| | - Amir Hossein Pourdavood
- Department of Surgery, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Iman Shamohammadi
- Department of Urology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
9
|
Rafati M, Hosseini SV, Moradian F, Zamani M, Khazraei H, Mokhtari M. Human Amniotic Membrane Effect on Perianal Fistula Healing in Rabbits: An Experimental Study. IRANIAN JOURNAL OF MEDICAL SCIENCES 2018; 43:473-478. [PMID: 30214099 PMCID: PMC6123562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Perianal fistula is a complicated disorder and most difficult to manage. New treatment methods would help surgeons to achieve a better outcome in patients with perianal fistula. Human amniotic membrane (HAM) has positive effects on wound healing in several conditions. The present study aimed to further determine the effect of HAM on wound healing of perianal fistula in rabbits. METHODS In a prospective experimental study, 14 male rabbits (aged 4-6 months and weighing 3-4 kg) were randomly divided into 2 groups. After 12 weeks, the high type perianal fistula was repaired with endorectal flap (ERF) and ERF plus HAM in the control and case groups, respectively. In all rabbits of the case group, a 1×1 cm width wrap of HAM was applied and fixed around the ERF site. Three weeks later, the repaired site of the perianal fistula was sent for pathologic wound healing scoring. The results were analyzed with the SPSS 21.0 software using Mann-Whitney test. RESULTS Six rabbits of each group survived the study period. There was a statistically significant difference in wound healing between the case and control groups (P<0.001). Wound healing process in the case group occurred better and faster than the control group. CONCLUSION HAM has an effective role in enhancing the ERF procedure and considered appropriate. A combination of HAM with other methods is recommended.
Collapse
Affiliation(s)
- Mohammad Rafati
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;
| | - Seyed Vahid Hosseini
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;
| | - Farid Moradian
- Department of Surgery, Yasouj University of Medical Sciences, Yasouj, Iran;
| | - Mozhdeh Zamani
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;
| | - Hajar Khazraei
- Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran;
| | - Maral Mokhtari
- Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
10
|
Alvandipour M, Gharedaghi B, Khodabakhsh H, Karami MY. Purse-String Versus Linear Conventional Skin Wound Closure of an Ileostomy: A Randomized Clinical Trial. Ann Coloproctol 2016; 32:144-9. [PMID: 27626025 PMCID: PMC5019967 DOI: 10.3393/ac.2016.32.4.144] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 07/14/2016] [Indexed: 01/07/2023] Open
Abstract
Purpose Infection is one of the most frequent complications that can occur after ileostomy closure. The incidence of wound infection depends on the skin closure technique, but there is no agreement on the perfect closure method for an ileostomy wound. The aim of this study was to evaluate the incidence of infection, the patient's approval, and the patient's pain between purse-string closure (PSC) and the usual linear closure (LC) of a stoma wound. Methods This randomized clinical trial enrolled 66 patients who underwent a stoma closure from February 2015 to May 2015 in Sari Emam Khomeini Hospital. Patients were divided into 2 groups according to the stoma closing method: the PSC group (n = 34) and the LC group (n = 32). The incidences of infection for the 2 groups were compared, and the patients' satisfaction and pain with the stoma were determined by using a questionnaire. Results Infection occurred in 1 of 34 PSC patients (2.9%) and in 7 of 32 LC patients (21.8%), and this difference was statistically significant (P = 0.021). Patients in the PSC group were more satisfied with the resulting wound scar and its cosmetic appearance at one month and three months after surgery (P = 0.043). Conclusion After stoma closure, PSC was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to LC. However, the healing period for patients who underwent PSC was longer than it was for those who underwent LC.
Collapse
Affiliation(s)
- Mina Alvandipour
- Department of Colorectal Surgery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Babak Gharedaghi
- Department of General Surgery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Khodabakhsh
- Department of Emergency Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Yasin Karami
- Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|