An overview of the topical management of wounds

Classification and Production of Polymeric Foams among the Systems for Wound Treatment

This work represents an overview on types of wounds according to their definition, classification and dressing treatments. Natural and synthetic polymeric wound dressings types have been analyzed, providing a historical overview, from ancient to modern times. Currently, there is a wide choice of materials for the treatment of wounds, such as hydrocolloids, polyurethane and alginate patches, wafers, hydrogels and semi-permeable film dressings. These systems are often loaded with drugs such as antibiotics for the simultaneous delivery of drugs to prevent or cure infections caused by the exposition of blood vessel to open air. Among the presented techniques, a focus on foams has been provided, describing the most diffused branded products and their chemical, physical, biological and mechanical properties. Conventional and high-pressure methods for the production of foams for wound dressing are also analyzed in this work, with a proposed comparison in terms of process steps, efficiency and removal of solvent residue. Case studies, in vivo tests and models have been reported to identify the real applications of the produced foams.

Hyaluronic acid, Manuka honey and Acemannan gel: Wound-specific applications for skin lesions

Healing of open wounds is of great medical importance. Wound healing is a complex process that aims to restore the function and structure of damaged tissue. This study was conducted to compare secondary intention healing of wounds treated daily with a topical application of commercially available hyaluronic acid (HA), Manuka honey (MH), Acemannan gel (AG), or a placebo. Bilateral wounds were surgically created on the backs of six sheep. At two and six weeks post-wound creation, biopsies were obtained to perform histological, immunohistochemical, and molecular analyses of the wound site. Daily clinical evaluations were performed and weekly photographs were taken of the wounds. HA treatment promoted a physiological progression of the healing process in all wound healing phases, while stimulating an abundant cutaneous adnexa and promoting rapid healing, representing the most compelling treatment. MH-treated wounds were slightly dry. However, the main effect of MH was to promote cell proliferation and neovascularization, with an overall pro-inflammatory effect. Results suggest that MH treatment enhances the healing process. AG treatment dehydrated the wounds and stimulated late granulation tissue and cell proliferation. Moreover, AG-treated wounds produced a mild late pro-inflammatory and neovascularization effect. Our data indicate that AG treatment can have a positive influence on moist wounds with abundant granulation tissue and exudate.

Encapsulation of Satureja khuzistanica extract in alginate hydrogel accelerate wound healing in adult male rats

BACKGROUND

Finding the best dressing for a specific wound had continued from the past to present. The aim of this study was to evaluate the effect of encapsulated extract of Satureja khuzistanica in hydrogel alginate at wound healing.

METHODS

Thirty-two male Wistar rats with a puncture wound in the back of the neck skin were divided randomly into four groups including a control group, Satureja khuzistanica-treated group, hydrogel alginate-treated group, and Satureja khuzistanica encapsulated in hydrogel alginate-treated group. Rats were treated for 22 days. The skin samples were taken on 3rd, 7th, 14th, and 22nd days after treatment for light microscopy. Results were analyzed in accordance with Kruskal-Wallis and Friedman test (for histopathology analysis) by using SPSS v.22 software.

RESULTS

Macroscopically evaluations and measurement of wound size showed increased wound healing process in the treated groups. The complete improvement was created on the 14th day. The wound site was not observed on the 22nd day. But the wound site was observed on the 22nd day in the control group. Also, comparison of the percentage of wound healing between the treated and control groups on 3rd, 7th, 14th, and 22nd days showed a significant difference (p < 0.05). Comparison of the H&E stained sections in the studied groups showed that treated groups were effective on wound healing in comparison with the control group.

CONCLUSIONS

Encapsulated extract of Satureja khuzistanica in hydrogel alginate may accelerate wound improvement and increase the rate of wound healing without scar formation.

Evaluation of the Wound Healing Activity of the Crude Extract of Leaves of Acanthus polystachyus Delile (Acanthaceae)

Background

Medicinal plants play indispensable roles to treat various ailments. Acanthus polystachyus is one of the medicinal plants used traditionally for treatment of wounds. However, there were no scientific reports documented so far on the wound healing activities of this plant. Thus, the present study provides a scientific evaluation for the wound healing potential of the crude extract of A. polystachyus leaves.

Methods

The crude extraction was carried out using 80% methanol. The crude extract was prepared in 5% (w/w) and 10% (w/w) ointment and evaluated for wound healing activity using excision, infected, and incision wound models in Swiss albino mice.

Results

Both 5%  and 10% (w/w) ointments significantly reduced period of epithelialization and increased wound contraction rate and tensile strength compared to the negative control group (P < 0.05). The wound healing activity of 10% (w/w) ointment treated group was greater than 5% (w/w) and nitrofurazone ointment treated groups in S. aureus infected wound model.

Conclusion

These results demonstrate that the crude extract of A. polystachyus leaves possesses wound healing activities. This justifies the traditional claimed use of the plant for treating uninfected and infected wounds caused by S. aureus.

An Open Label, Randomized, Comparative, Parallel Group, Multicenter, Prospective, Interventional, Clinical Study to Evaluate Efficacy and Safety of "AHPL/AYTOP/0113" in Comparison with "Framycetin Sulphate Cream" in Acute Wounds

Objectives:

The main objective of the present study was to assess efficacy and safety of AHPL/AYTOP/0113 cream, a polyherbal formulation in comparison with Framycetin sulphate cream in acute wounds.

Methodology:

It was an open label, randomized, comparative, parallel group and multi-center clinical study. Total 47 subjects were randomly assigned to Group-A (AHPL/AYTOP/0113 cream) and 42 subjects were randomly assigned to Group-B (Framycetin sulphate cream). All the subjects were advised to apply study drug, thrice daily for 21 days or up to complete wound healing (whichever was earlier). All the subjects were called for follow up on days 2, 4, 7, 10, 14, 17 and 21 or up to the day of complete wound healing. Data describing quantitative measures are expressed as mean ± SD. Comparison of variables representing categorical data was performed using Chi-square test.

Results:

Group-A subjects took significantly less (P < 0.05) i.e., (mean) 7.77 days than (mean) 9.87 days of Group-B subjects for wound healing. At the end of the study, statistically significant better (P < 0.05) results were observed in Group-A than Group-B in mean wound surface area, wound healing parameters and pain associated with wound. Excellent overall efficacy and tolerability was observed in subjects of both the groups. No adverse event or adverse drug reaction was noted in any subject of both the groups.

Conclusion:

AHPL/AYTOP/0113 cream proved to be superior to Framycetin sulphate cream in healing of acute wounds.

Application of hyaluronic acid in the healing of non-experimental open wounds: A pilot study on 12 wounds in 10 client-owned dogs

Aim:

Veterinarians have frequently to deal with wounds to the skin, subcutis, and underlying muscle. The aim was to explore the application of hyaluronic acid (HA)-containing dressing on open skin wounds in dogs. The progress of healing was assessed by wound area reduction and two scoring scales applied in human medicine.

Materials and Methods:

Ten client-owned dogs with 12 cutaneous open wounds healed by the second intention were included. All wounds were treated using available in commerce HA-containing wound dressing from admission to complete re-epithelialization. At every clinical examination, wound area and scale scoring assessments were performed.

Results:

After debridement, an increased wound size was obtained while an improvement was determined by both grading systems. The median numbers of return to the clinic for bandage change were 5 times. The median time to complete wound healing was 34.5 days. The mean wound area at day 7, 14, 21, and 28 were, respectively, 90.4%, 47.7%, 22.4%, and 14.8% of the original size (for linear measurement) and 95.5%, 54.4%, 23.10%, and 14.8% of the original size (for software measurement). Regarding wound healing assessment tools, the agreement between two operators was considered high for both scales.

Conclusions:

HA-containing dressing may be a possible wound treatment for cutaneous open wounds in dogs. The assessment of wound quality using scale scoring system could be useful especially in the 1^st week and to direct clinical decision-making process.

Wound Care

Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve.

Preparation and evaluation of biocomposites as wound dressing material

Collagen was isolated from the chrome containing leather waste (CCLW) which is a major solid waste in leather industry. Composite films were made using sago starch (SG), soya protein (SY), and collagen (C) and were cross linked with glutaraldehyde (G).The films prepared were characterized for their physico chemical properties like tensile strength, infrared spectra, thermogravimetric analysis, surface morphology, and water absorption studies. Better mechanical properties and surface morphology were observed for SG-SY-G-C films compared to other films prepared using collagen. The composite films prepared were used as wound dressing material on the experimental wounds of rats and healing pattern was evaluated using planimetric, biochemical, and histopathological studies. These studies have revealed better wound healing capacity of SG-SY-G-C film and utilization of CCLW in the preparation of value added product like wound dressing material.

Silver nanoparticles as real topical bullets for wound healing

Nanotechnology is on the threshold of providing a host of new materials and approaches, revolutionizing the medical and pharmaceutical fields. Several areas of medical care are already profiting from the advantage that nanotechnology offers. Recently, silver nanoparticles are attracting interest for a clinical application because of its potential biological properties such as antibacterial activity, anti-inflammatory effects, and wound healing efficacy, which could be exploited in developing better dressings for wounds and ulcers. This article reviews the role of silver nanoparticles in wound healing.

Evidence-based wound management: a systematic review of therapeutic agents to enhance granulation and epithelialization

Successful management of open wounds in dogs requires knowledge of the physiology of wound healing and application of that knowledge to choose appropriate therapeutic intervention. The authors' objective was to investigate whether or not there are any available therapeutic agents that enhance granulation or epithelialization of open wounds in dogs. Based on the literature identified in the authors' review, there is insufficient evidence to make a recommendation for or against any of the topical wound agents or procedures studied.

Topical treatments in equine wound management

Wound repair is a complex series of coordinated events regulated by a delicately orchestrated cascade of cytokines and growth factors that restore the structural integrity of damaged tissue. Manipulation of the growth factor profile or wound environment through topical application of therapeutic agents could positively influence the rate and quality of wound repair. Transforming growth factor-beta,platelet-rich plasma, activated macrophage supernatant, and growth hormone are sources of mediators that may facilitate wound healing. Solcoseryl, ketanserin, tripeptide- and tetrapeptide-copper complexes, maltodextrin, live yeast cell derivative, corticosteroids,aloe vera, acemannan, phenytoin, honey, sugar, and maggots may modify the wound environment and promote repair. The process of wound healing is complex, however, and it is currently unknown whether any one agent can ameliorate all issues of repair or cover all vulnerabilities of impaired wound healing.

Principles of wound management of small mammals: hedgehogs, prairie dogs, and sugar gliders

The management of wounds is a common scenario for the exotic animal practitioner. When presented with such cases, the practitioner must first adhere to the firmly established principles of wound healing, and then modify available treatment modalities to fit the needs of the species at hand. Practicing wound management on exotic patients can be challenging due to their small size, unusual anatomy, difficult behaviors, and tendency for developing secondary stress-related health problems. A review of the stages of wound healing as well as traditional wound management techniques is provided here. This review is followed by a summary of typical wounds encountered in hedgehogs, prairie dogs, and sugar gliders, as well anatomic, physiologic, and behavioral characteristics that should be taken into consideration when managing wounds on such species.

Case 40: ward management. Ward sister who failed to manage her ward appropriately

This article reviews the factors that impinge on the application of topical medications in wound care. The role of systemic and topical antibiotics in wound care is reviewed. Similarly, two antiseptics — iodine and silver, of great current interest in wound management — are scrutinized. The value of these topical agents in the management of wound bioburden should be ascertained from the perspective of understanding the advantages and disadvantages of their use and not established from what is currently the trend.