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ŞENSOY E, GÜNEŞ E, ERDAL MO. Determination of the Effects of Ankaferd Wound Dressing on the Wound Healing Process in Rats. Turk J Pharm Sci 2024; 21:95-103. [PMID: 38742756 PMCID: PMC11096788 DOI: 10.4274/tjps.galenos.2023.03746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/13/2023] [Indexed: 05/16/2024]
Abstract
Objectives The effects of a composite nanofiber wound dressing material consisting of a polyvinylidene alcohol and polyvinylidene pyrrolidone polymer mixture with a hemostatic agent doped with Ankaferd Blood Stopper (ABS) on the healing of experimentally induced dermal wounds in rats were examined. Materials and Methods Rats were divided into 4 groups (n= 6). Histological material was examined on tissues taken from the wound site, whereas total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) analyses were performed on blood samples taken from the cardia. The material that was produced had hydrophilic properties, and both the ABS-doped and-undoped forms of the material positively affected wound healing. Results In the histopathological examinations, macroscopic evaluations revealed a statistically significant difference between the groups in terms of wound diameter, reepithelialization, and inflammation formation (p= 0.019). In parallel with wound healing and histological outcomes, TAS values increased in the ABS-doped groups, and TOS and OSI values decreased in the wound dressing groups (p < 0.05). Conclusion It was concluded that the ABS-dopped dressing did not have a negative effect on wound healing, it accelerated healing, and it could be used effectively and safely to treat skin injuries. However, further studies are needed to evaluate the clinical and histopathological benefits and potential adverse effects of wound dressings produced using ABS-doped polymers on wound healing.
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Affiliation(s)
- Erhan ŞENSOY
- Karamanoğlu Mehmetbey University Faculty of Medicine, Department of Midwifery, Karaman, Türkiye
| | - Eda GÜNEŞ
- Necmettin Erbakan University Faculty of Tourism, Department of Gastronomy and Culinary Arts, Konya, Türkiye
| | - Mehmet Okan ERDAL
- Necmettin Erbakan University Meram Vocational School, Department of Property Protection and Security, Konya, Türkiye
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Poehnert D, Neubert L, Winny M. Comparison of adhesion prevention capabilities of the modified starch powder-based medical devices 4DryField ® PH, HaemoCer™ PLUS and StarSil ® in the Optimized Peritoneal Adhesion Model. Int J Med Sci 2024; 21:424-430. [PMID: 38250612 PMCID: PMC10797680 DOI: 10.7150/ijms.90024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/08/2023] [Indexed: 01/23/2024] Open
Abstract
Background and Objectives: The rat Optimized Peritoneal Adhesion Model (OPAM) was developed to provoke adhesion formation with high reproducibility in incidence and extent. In a recent study, the starch-based hemostats 4DryField PH and Arista AH were tested for their capabilities to prevent adhesion formation, the former one certified for adhesion prevention and hemostasis, the latter one only certified for hemostasis. As two further starch-based hemostats, i.e., HaemoCer PLUS and StarSil, have officially been certified for adhesion prevention in the meantime, the present study was conducted to examine their efficacy. Materials and Methods: For this purpose, all three products were applied as a powder that was mixed in situ with saline solution to form a barrier gel. Adhesions were scored using the established macroscopically scoring systems by Lauder and Hoffmann, as well as histopathologically using the score by Zühlke. Animals receiving saline solution solely served as controls. Results: As previously published, 4DryField PH reduced peritoneal adhesions significantly. In contrast, HaemoCer PLUS and StarSil did not lead to a statistically significant reduction of adhesion formation. When comparing 4DryField PH, HaemoCer PLUS and StarSil, 4DryField PH was significantly more effective in preventing peritoneal adhesions. The results of the macroscopic investigation were confirmed by histopathological evaluations. Conclusions: Only 4DryField PH but neither HaemoCer PLUS nor StarSil were capable to effectively prevent adhesion formation, corroborating the assumption that starch-based hemostats do not generally have the capability to act as effective adhesion prevention devices.
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Affiliation(s)
- Daniel Poehnert
- Department of General, Visceral and Transplantation Surgery, Hanover Medical School, Carl-Neuberg-Str. 1, 30625 Hanover, Germany
| | - Lavinia Neubert
- Institute of Pathology, Hanover Medical School, Carl-Neuberg-Str. 1, 30625 Hanover, Germany
| | - Markus Winny
- Department of General, Visceral and Transplantation Surgery, Hanover Medical School, Carl-Neuberg-Str. 1, 30625 Hanover, Germany
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Ensan B, Bathaei P, Nassiri M, Khazaei M, Hassanian SM, Abdollahi A, Ghorbani HR, Aliakbarian M, Ferns GA, Avan A. The Therapeutic Potential of Targeting Key Signaling Pathways as a Novel Approach to Ameliorating Post-Surgical Adhesions. Curr Pharm Des 2022; 28:3592-3617. [PMID: 35466868 DOI: 10.2174/1381612828666220422090238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/24/2022] [Accepted: 02/04/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Peritoneal adhesions (PA) are a common complication of abdominal operations. A growing body of evidence shows that inhibition of inflammation and fibrosis at sites of peritoneal damaging could prevent the development of intra-abdominal adhesions. METHODS A search of PubMed, Medline, CINAHL and Embase databases was performed using the keywords 'postsurgical adhesion', 'post-operative adhesion', 'peritoneal adhesion', 'surgery-induced adhesion' and 'abdominal adhesion'. Studies detailing the use of pharmacological and non-pharmacological agents for peritoneal adhesion prevention were identified, and their bibliographies were thoroughly reviewed to identify further related articles. RESULTS Several signaling pathways, such as tumor necrosis factor-alpha, tissue plasminogen activator, and type 1 plasminogen activator inhibitor, macrophages, fibroblasts, and mesothelial cells play a key part in the development of plasminogen activator. Several therapeutic approaches based on anti-PA drug barriers and traditional herbal medicines have been developed to prevent and treat adhesion formation. In recent years, the most promising method to prevent PA is treatment using biomaterial-based barriers. CONCLUSION In this review, we provide an overview of the pathophysiology of adhesion formation and various agents targeting different pathways, including chemical agents, herbal agents, physical barriers, and clinical trials concerning this matter.
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Affiliation(s)
- Behzad Ensan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parsa Bathaei
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammadreza Nassiri
- Recombinant Proteins Research Group, The Research Institute of Biotechnology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Majid Khazaei
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mahdi Hassanian
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Abdollahi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Reza Ghorbani
- Orology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Aliakbarian
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, BN1 9PH, UK
| | - Amir Avan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Özden H, Saygun O, Daphan ÇE, Aydınuraz K, Aydın O, Tanrıkulu FB, Döm S. The Effects of Thymoquinone (Kalonji) on Abdominal Adhesion in Experimental Abdominal Adhesive Model. Indian J Surg 2020. [DOI: 10.1007/s12262-019-01941-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Beyazit F, Buyuk B. An immunohistochemistry and histopathological study of ankaferd blood stopper in a rat model of cervical inflammation. ACTA ACUST UNITED AC 2019; 65:183-190. [PMID: 30892442 DOI: 10.1590/1806-9282.65.2.183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 05/27/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Ankaferd Blood Stopper (ABS) is a medicinal plant extract used topically as a hemostatic, anti-inflammatory, and anti-oxidant agent. Its cytoprotective effect mainly depends on its pleiotropic properties by modulating inflammatory mediators such as IL-1β, IL-6, and TNF-α. This study aims to test the possible therapeutic effect of ABS in the treatment of erosive and inflammatory conditions occurring in the uterine cervix. METHODS Twenty-four female Wistar Albino rats were used in the present study. Trichloracetic acid was applied intravaginally to establish an experimental rat model of cervicitis. The rats were randomly divided into three groups: group I (injury), group II (injury+isotoinc saline), and group III (injury+ABS). After 3 estrous cycles of ABS and isotonic saline treatment, the amount of inflammation, vascular congestion and erosion were evaluated in the cervical tissues by using a modified semi-quantitative scale of 0-3. Immunohistochemical staining with monoclonal antibodies against IL-1β was also performed. RESULTS Compared with group I and II, the ABS group showed the least inflammatory cell infiltration, vascular congestion and cervical erosion, compared with the ABS group prominent IL-1β staining observed in group I and group II. CONCLUSION Our data suggest that ABS is a highly effective alternative to induce normal cervical epithelium and can be used safely in the treatment of cervical inflammation with or without cervical erosion.
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Affiliation(s)
- Fatma Beyazit
- Canakkale Onsekiz Mart Universitesi, Obstetrics and Gynecology, Merkez/ Canakkale, Canakkale, Turkey
| | - Basak Buyuk
- Canakkale Onsekiz Mart Universitesi, Department of Histology and Embryology, Merkez/ Canakkale, Canakkale, Turkey
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Gökçelli U, Ercan UK, İlhan E, Argon A, Çukur E, Üreyen O. Prevention of Peritoneal Adhesions by Non-Thermal Dielectric Barrier Discharge Plasma Treatment on Mouse Model: A Proof of Concept Study. J INVEST SURG 2019; 33:605-614. [PMID: 30644787 DOI: 10.1080/08941939.2018.1550542] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Purposes: Formation of peritoneal adhesions is a common consequence of abdominopelvic surgeries and remarkably increases the mortality and morbidity. Moreover, peritoneal adhesions linked to chronic abdominopelvic pain and infertility in women. Various attempts for prevention of peritoneal adhesions were reported. However, these methods either remain insufficient to prevent formation of peritoneal adhesions or carry some practical limitations and thus, there is a need for novel techniques that could effectively decrease the formation of peritoneal adhesions. The aim of the present prospective, randomized, controlled, and single blinded study was to evaluate the effect of non-thermal atmospheric plasma (NTAP) treatment on prevention of peritoneal adhesions. Materials and Methods: Sixteen male CD-1 mice were randomly divided into two groups: control and plasma. Excisional and abrasion adhesion models were generated on the peritoneal side wall and cecum, respectively. Ten days after creating adhesion models, mice were sacrificed and adhesion formations were evaluated macroscopically using Knightly's and Linsky's grading systems to assess the intensity and extent of adhesions, respectively. Zühlke's grading system was used for microscopic assessment of adhesions. Results: The mean scores for peritoneum and cecum in control group according to Knightly's grading system were determined as 3.3 and 2.6, respectively. In NTAP-treated group, Knightly's score was determined as 1.6 and 0.5 for peritoneum and cecum, respectively. NTAP treatment reduced Linsky's score from 3.8 to 1.3 and 2.1 to 1.1 on peritoneum and cecum. Finally, in microscopic evaluation, NTAP treatment reduced Zühlke's score from 3.4 to 1.5 and 2.6 to 1.3 for peritoneum and cecum, respectively. Conclusions: The results of the present proof of concept study suggest that NTAP could be a novel method to reduce and/or prevent the formation of peritoneal adhesions after abdominopelvic surgeries.
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Affiliation(s)
- Uğur Gökçelli
- Department of General Surgery, İzmir Bozyaka Research and Training Hospital, University of Health Sciences, İzmir, Turkey
| | - Utku Kürşat Ercan
- Department of Biomedical Engineering, İzmir Katip Çelebi University, İzmir, Turkey
| | - Enver İlhan
- Department of General Surgery, İzmir Bozyaka Research and Training Hospital, University of Health Sciences, İzmir, Turkey
| | - Asuman Argon
- Department of Pathology, İzmir Bozyaka Research and Training Hospital, University of Health Sciences, İzmir, Turkey
| | - Elif Çukur
- Department of Biomedical Engineering, İzmir Katip Çelebi University, İzmir, Turkey
| | - Orhan Üreyen
- Department of General Surgery, İzmir Bozyaka Research and Training Hospital, University of Health Sciences, İzmir, Turkey
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Poehnert D, Neubert L, Klempnauer J, Borchert P, Jonigk D, Winny M. Comparison of adhesion prevention capabilities of the modified starch powder-based medical devices 4DryField ® PH and Arista™ AH in the Optimized Peritoneal Adhesion Model. Int J Med Sci 2019; 16:1350-1355. [PMID: 31692813 PMCID: PMC6818195 DOI: 10.7150/ijms.33277] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 07/22/2019] [Indexed: 12/31/2022] Open
Abstract
Adhesion barriers can be based on numerous substances. In the rat Optimized Peritoneal Adhesion Model (OPAM) the starch-based hemostats 4DryField and Arista were tested for their capability to act in a preventive manner against adhesion formation (applied as a powder that was mixed in situ with saline solution to form a barrier gel). Adhesions were scored using the established scoring systems by Lauder and Hoffmann, as well as histopathologically using the score by Zühlke. Animals receiving saline solution were used as controls. As previously published, 4DryField reduced peritoneal adhesions significantly. However, Arista did not lead to a statistically significant reduction of adhesion formation. When comparing 4DryField and Arista applied in the same manner, only 4DryField was significantly effective in preventing peritoneal adhesions. Histopathological evaluations confirmed the results of the macroscopic investigation, leading to the conclusion that starch-based hemostats do not generally have the capability to function as effective adhesion prevention devices.
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Affiliation(s)
- Daniel Poehnert
- Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany
| | - Lavinia Neubert
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Juergen Klempnauer
- Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany
| | - Paul Borchert
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Danny Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Markus Winny
- Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany
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Dokur M, Uysal E. Evaluation of botulinum toxin type A effectiveness in preventing postoperative intraperitoneal adhesions. Ann Surg Treat Res 2017; 93:50-56. [PMID: 28706891 PMCID: PMC5507791 DOI: 10.4174/astr.2017.93.1.50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 01/20/2017] [Accepted: 01/24/2017] [Indexed: 12/20/2022] Open
Abstract
Purpose Postoperative intraperitoneal adhesions (PIAs) are one of the most important problems surgeons have to face after laparotomies. In this study, we aimed to evaluate the effectiveness of local application of botulinum toxin type A (BoNT-A) in various dosages on the prevention of intra-abdominal adhesions in rats with experimental intra-abdominal adhesions. Methods Forty Wistar Albino female rats were randomly separated into 4 groups. The 4 groups were determined as follows: Control (group 1, n = 10); Sham (group 2, n = 10); 10-µg/kg low-dose BoNT-A (group 3, n = 10) and 30-µg/kg high-dose BoNT-A (group 4, n = 10). Subserosal injuries were created on the caecum of all rats. Laparotomy was performed on the fifth day. Adhesion scores, histopathological examination, and E-cadherin expression levels were evaluated. Results General adhesion scores for groups 1 and 2 were determined to be significantly high when compared to group 4 (P < 0.001). A significant difference was also determined between groups 3 and 4 in terms of general adhesion scores (P < 0.05). In pair comparisons, a significant decrease in high-dose BoNT-A group (group 4) when compared to groups 1 and 2 in terms of neovascularization, fibroblast density, collagen deposition and inflammatory cell count was determined (P < 0.05). Conclusion A significant decrease was observed only in postoperative PIAs in the high-dose BoNT-A group between all 4 rat-groups with experimentally created postoperative PIAs. In this study, high-dose BoNT-A is determined to be an effective agent in preventing postoperative PIAs.
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Affiliation(s)
- Mehmet Dokur
- Department of Emergency Medicine, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Erdal Uysal
- Department of General Surgery, Sanko University School of Medicine, Gaziantep, Turkey
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