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Medicine Mar 2017Burns are common event and associated with a high incidence of death, disability, and high costs. Centella asiatica (L.) is a medicinal herb, commonly growing in humid... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Burns are common event and associated with a high incidence of death, disability, and high costs. Centella asiatica (L.) is a medicinal herb, commonly growing in humid areas in several tropical countries that improve wound healing. On the basis of previous studies, we compared the efficacy of Centiderm versus silver sulfadiazine (SSD) in partial thickness burning patients.
METHODS
Study population comprised burn victims referred to Velayat Burning Hospital at Rasht, Iran. The intervention group received Centiderm and control group SSD cream. Burn wounds were treated once daily at home. All of the wounds were evaluated till complete healing occurred and at the admission, days 3, 7, 14 objective signs; visual acuity score (VAS) and subjective signs were recorded. Re-epithelialization time and complete healing days were recorded. We used random fixed block for randomization. The randomization sequence was created using the computer. Patients and burning specialist physician were blinded.
RESULTS
Seventy-five patients randomized into 2 groups; (40 patients: Centiderm group; 35 patients: SSD group). The mean age of them was 30.67 ± 9.91 years and 19 of them were male (31.7%). Thirty patients in Centiderm and 30 patients in SSD group were analyzed. All of objective and subjective signs and mean of re-epithelialization and complete healing were significantly better in Centiderm group rather than SSD group (P < 0.05). There was no infection in Centiderm group.
CONCLUSIONS
We showed that use of Centiderm ointment not only improved the objective and subjective signs in less than 3 days, but also the re-epithelialization and complete healing rather than SSD without any infection in the subjects.
Topics: Administration, Cutaneous; Adult; Anti-Infective Agents, Local; Burns; Centella; Female; Humans; Male; Phytotherapy; Plant Extracts; Re-Epithelialization; Silver Sulfadiazine; Triterpenes; Young Adult
PubMed: 28248871
DOI: 10.1097/MD.0000000000006168 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Mar 2020Studies evaluating the recovery of the zone of stasis is an important issue in burn research. In this study, we aimed to evaluate and compare the efficiency of an...
BACKGROUND
Studies evaluating the recovery of the zone of stasis is an important issue in burn research. In this study, we aimed to evaluate and compare the efficiency of an anti-ischemic and vasodilatory agent, a topical agent containing 2% nitroglycerin with 1% silver sulfadiazine, and bacitracin-neomycin sulfate in the zone of stasis histomorphologically and immunohistochemically.
METHODS
We conducted an experimental study using 30 Wistar-Albino rats, each weighing 250-300 grams. The rats were divided randomly into five groups (six rats in each group). In this study, the "comb model," which was deemed to be the most appropriate experimental model to produce an injury with predictable zones and was first described by Regas and Erhlich, was used. The following were applied to the zone of stasis after creating a burn model in 0, 24, and 48 hours: topical 2% nitroglycerin, 1% silver sulfadiazine, bacitracin-neomycin sulfate, and Vaseline-lanolin (sham). After 72 hours, biopsies were performed from the zone of stasis and evaluated by histomorphological and immunohistochemical CD 34 (expressed in human endothelial and hematopoietic cells) and D 2-40 (expressed in the endothelium of lymphatic capillaries) methods. The results were evaluated using the chi-square test.
RESULTS
Compared with the other groups, a statistically significant difference was found in edema, inflammation, and vascular proliferation in the nitroglycerin group. Significantly more intense staining for CD 34 was found in the nitroglycerin group compared with the other groups. Immunohistochemical staining for D 2-40 was also found statistically significant in the nitroglycerin group (p<0.05).
CONCLUSION
A topical containing 2% nitroglycerin increases vascular proliferation in the zone of stasis affects the recovery and may be used as a new agent in burn injury treatment.
Topics: Animals; Burns; Disease Models, Animal; Edema; Inflammation; Male; Nitroglycerin; Rats; Silver Sulfadiazine; Skin
PubMed: 32185753
DOI: 10.14744/tjtes.2019.00005 -
Life (Basel, Switzerland) Apr 2022Paediatric second-degree burn injuries are a significant source of medical challenges to the population that may cause severe, lifelong complications. Currently, there... (Review)
Review
BACKGROUND
Paediatric second-degree burn injuries are a significant source of medical challenges to the population that may cause severe, lifelong complications. Currently, there are dozens of therapeutic modalities and we aimed to summarise their reported outcomes and determine their effectiveness, compared to the widely used silver sulphadiazine (SSD).
METHODS
We conducted the meta-analysis and systematic review of randomised controlled trials (RCTs), which investigated the performance of dressings in acute paediatric partial-thickness burns. The evaluated endpoints were time until wound closure, grafting and infection rate, number of dressing changes and length of hospitalisation.
RESULTS
Twenty-nine RCTs were included in the qualitative and 25 in the quantitative synthesis, but only three trials compared SSD directly to the same intervention (Biobrane). Data analysis showed a tendency for faster healing times and a reduced complication rate linked to biosynthetic, silver foam and amnion membrane dressings. A substantial difference was found between the number of dressing changes associated with less pain, narcosis and treatment duration.
CONCLUSIONS
Considerable between-study heterogeneity was caused by the unequal depth subcategory ratio and surface area of the injuries; therefore, no significant difference was found in the main outcomes. Further research is necessary to establish the most effective treatment for these burns.
PubMed: 35629287
DOI: 10.3390/life12050619 -
Acta Cirurgica Brasileira 2022To evaluate the morphometric, macroscopic and microscopic aspects of experimentally induced partial-thickness burns in rats treated with different silver-based dressings.
PURPOSE
To evaluate the morphometric, macroscopic and microscopic aspects of experimentally induced partial-thickness burns in rats treated with different silver-based dressings.
METHODS
Wistar rats were used, divided into six treatments: saline (NaCl 0.9%); silver sulfadiazine 1%; Silvercel; Mepilex Ag; Aquacel Ag and Acticoat. The animals were monitored daily and euthanized at 7, 14 and 30 days after injury induction (DAI).
RESULTS
At 7 DAI, necrosis/crust was greater in control, silver sulfadiazine and Mepilex Ag treatments, granulation tissue was induced by Aquacel Ag, polymorphonuclear infiltrate (PMN) infiltration was intensified by Mepilex Ag; mononuclear infiltrate (MN) infiltration and angiogenesis were increased by Silvercel. At 14 DAI, hemorrhage was decreased by Silvercel and Mepilex Ag, PMN infiltration increased by Acticoat. At 30 DAI, angiogenesis was greater in the Acticoat treatment and fibroblasts were increased by Acticoat and Mepilex Ag. Collagen was induced at 14 DAI by silver sulfadiazine and Aquacel Ag and, at 30 DAI, by silver sulfadiazine and Silvercel treatments.
CONCLUSIONS
Silvercel and Acticoat presented better results than the other products. However, all the dressings were better than the control at some point during the process, and may contribute to the healing of partial thickness burns. Silvercel and Aquacel Ag treatments induced better cosmetic outcomes regarding wound closure and scarring.
Topics: Rats; Animals; Silver Sulfadiazine; Silver; Carboxymethylcellulose Sodium; Rats, Wistar; Bandages; Burns
PubMed: 36449949
DOI: 10.1590/acb370801 -
Revista Da Escola de Enfermagem Da U S P 2016To evaluate the effectiveness of hyaluronic acid in the healing of partial thickness burns. (Review)
Review
OBJECTIVE
To evaluate the effectiveness of hyaluronic acid in the healing of partial thickness burns.
METHOD
Systematic review of randomized controlled trials on the use of hyaluronic acid for the topical treatment of skin burns, based on recommendations of the Cochrane Handbook for Systematic Reviews of Interventions.
RESULTS
Two randomized controlled trials that analyzed 143 patients with partial thickness burns and/or deep partial thickness burns were selected. They compared the application of hyaluronic acid 0.2% associated to silver sulfadiazine 1% 5g/cm2 versus silver sulfadiazine 1% 5g/cm2 alone for the outcome of complete healing.
CONCLUSION
This review emphasizes the need for new well-designed randomized controlled trials to establish the therapeutic relevance of hyaluronic acid with respect to the healing of burns of partial thickness or deep partial thickness.
OBJETIVO
Avaliar a efetividade do ácido hialurônico na cicatrização de queimaduras de espessura parcial.
MÉTODO
Revisão sistemática de ensaios clínicos randomizados sobre a utilização de ácido hialurônico no tratamento tópico de queimaduras de pele, baseada nas recomendações do Cochrane Handbook for Systematic Reviews of Interventions.
RESULTADOS
Foram recuperados dois ensaios clínicos randomizados que analisaram 143 pacientes portadores de queimaduras de espessura parcial e/ou espessura parcial profunda, comparando a aplicação de Ácido Hialurônico 0,2% associado à Sulfadiazina de Prata 1% 5g/cm2, versus Sulfadiazina de Prata 1% 5g/cm2 isolada, para o desfecho cicatrização completa.
CONCLUSÃO
Esta revisão enfatiza a necessidade de novos ensaios clínicos randomizados bem delineados para estabelecimento da relevância terapêutica do ácido hialurônico no que tange à cicatrização de queimaduras de espessura parcial ou espessura parcial profunda.
Topics: Burns; Humans; Hyaluronic Acid; Randomized Controlled Trials as Topic; Treatment Outcome; Wound Healing
PubMed: 27556725
DOI: 10.1590/S0080-623420160000400020 -
Evidence-based Complementary and... 2023is traditionally used to treat skin burns and microbial infections. However, experimental studies on this plant are rare. Furthermore, the aim of this study was to...
is traditionally used to treat skin burns and microbial infections. However, experimental studies on this plant are rare. Furthermore, the aim of this study was to investigate the effects of , a Moroccan herbal remedy, on the healing of deep second-degree burns in rats with a silver sulfadiazine group. This research was also carried out to confirm if had antibacterial capabilities. Under typical burn procedures, each rat received a deep second-degree burn on the upper back. The burns were treated regularly with control groups (control and control VH), silver sulfadiazine (SDD) in group 3, ethanolic extract (CHEE) in group 4, and aqueous extract (CHAE) in group 5. Throughout the treatment, digital photography was used to measure rat responses to the treatment until day 18. After the scar biopsy at the end of the study, histological parameters (inflammatory cells, collagen, epithelialization, fibrosis, and granulation tissue) were assessed. Using the well technique, the antibacterial activity of the extracts was tested against CIP 483, CIP 5262, CIP 53126, CIP 82118, and CIP 8039, and the results showed important activities of the ethanolic and aqueous extracts against the five species tested with MICs of 2 and 4 mg/mL, respectively. In the aqueous extract group, the wound healed faster. In addition, the healing rate in the extracts (CHEA and CHEE) group was faster than in the silver sulfadiazine and control groups. In the group, maximum wound surface recovery was observed at the same time, as it was not noted in the silver sulfadiazine group. Pathologically, epithelialization was more marked in wounds treated with extracts (CHE). Angiogenesis and inflammatory cells were considerably lower in the CHE group than in the silver and other control groups. However, elastic fibers were considerable in the CHE-treated group. In histological examination, the group had a low incidence of angiogenesis and inflammation, indicating that this group had less wound scarring. Collagen and burn wound healing were both faster in the group. The findings of this study suggest that , as indicated by traditional medicine, is a promising natural source for the management of wound healing.
PubMed: 37114146
DOI: 10.1155/2023/5855948 -
Journal of Pharmacy & Bioallied Sciences Mar 2012A new Hydrogel containing silver Sulfadiazine (SSD) was developed for enhanced burns wound healing. The hydrogel was prepared by cross-linking of PVA and Chitosan by...
A new Hydrogel containing silver Sulfadiazine (SSD) was developed for enhanced burns wound healing. The hydrogel was prepared by cross-linking of PVA and Chitosan by freeze thawing method. Their gel properties, moisture retaining capacity, fluid uptake capacity, in vitro release study, in vivo burn healing effect were evaluated. Chitosan and PVA cross linking decreased gel fraction upto 70% determined the good gel properties. This cross linked hydrogel increased the Swelling ratio and Water vapour transmission rate (WVTR) which provides the sustained release of drug and moist environment for healing respectively. The hydrogel containing 7.5% of PVA, 0.75% of chitosan found to have increased gel strength, higher water vapour transmission rate and fluid uptake capacity suitable for faster healing of burns. This hydrogel also sustained the release of 1% SSD required for longer antimicrobial activity and found better in vivo burn healing capacity as compared to marketed preparation. Thus hydrogel containing 7.5% of PVA, 0.75% of chitosan and 1% SSD is a potential burns dressing with better gel properties and excellent burns healing capacity.
PubMed: 23066206
DOI: 10.4103/0975-7406.94131 -
Micromachines Jan 2023The growing demand for personalized medicine requires innovation in drug manufacturing to combine versatility with automation. Here, three-dimensional (3D) printing was...
3D Printed Chitosan/Alginate Hydrogels for the Controlled Release of Silver Sulfadiazine in Wound Healing Applications: Design, Characterization and Antimicrobial Activity.
The growing demand for personalized medicine requires innovation in drug manufacturing to combine versatility with automation. Here, three-dimensional (3D) printing was explored for the production of chitosan (CH)/alginate (ALG)-based hydrogels intended as active dressings for wound healing. ALG hydrogels were loaded with 0.75% w/v silver sulfadiazine (SSD), selected as a drug model commonly used for the therapeutic treatment of infected burn wounds, and four different 3D CH/ALG architectures were designed to modulate the release of this active compound. CH/ALG constructs were characterized by their water content, elasticity and porosity. ALG hydrogels (Young's modulus 0.582 ± 0.019 Mpa) were statistically different in terms of elasticity compared to CH (Young's modulus 0.365 ± 0.015 Mpa) but very similar in terms of swelling properties (water content in ALG: 93.18 ± 0.88% and in CH: 92.76 ± 1.17%). In vitro SSD release tests were performed by using vertical diffusion Franz cells, and statistically significant different behaviors in terms of the amount and kinetics of drugs released were observed as a function of the construct. Moreover, strong antimicrobial potency (100% of growth inhibition) against and was demonstrated depending on the type of construct, offering a proof of concept that 3D printing techniques could be efficiently applied to the production of hydrogels for controlled drug delivery.
PubMed: 36677198
DOI: 10.3390/mi14010137 -
Advances in Pharmacological and... 2022Estrogens are a group of sex hormones which have receptors on the skin and lead to increased cells and wound healing. Normally isoflavonoids are present in Boiss....
Estrogens are a group of sex hormones which have receptors on the skin and lead to increased cells and wound healing. Normally isoflavonoids are present in Boiss. (Leguminosae). Therefore, the present study was conducted to evaluate the presence of isoflavonoids in rich fraction of flavonoid and evaluate its wound healing effect accordingly. Flavonoids were evaluated by LCMS. Scratch was conducted and the medium culture was treated with the rich fraction of flavonoid (RFF) and was compared with nontreated culture during 48 hours. In addition, in vivo full-thickness wound healing evaluation was performed on rats. The rats were put into four groups and treated on a daily basis for 21 days with a cream containing 1.5% of the RFF (group 1), silver sulfadiazine (group 2), and Vaseline (group 3) separately. The nontreated group (group 4) was created for a better comparison. During the examination, wound size was evaluated and histopathological examination was performed. Herbal analysis detected 11 flavonoids, including 2 isoflavonoids, Calycosin-7-O-beta-D-glucoside and Formononetin, in the RFF. In vitro scratch wound healing showed significant improvement with RFF treatment in comparison to nontreated medium. Furthermore, in vitro drug release of ointment showed a stationary line during 24 h and 0.14 mg/ml of flavonoid penetrated the skin. In vivo wound size evaluation showed significant improvement in the group treated with the RFF in comparison to other groups. Histopathological results indicated that congestion, edema, inflammation, necrosis, and angiogenesis decreased during the examination and fibroblast proliferation fibrosis epithelization was increased especially in the RFF group in comparison to the silver sulfadiazine and free groups. In conclusion, showed that wound healing activity in both in vitro and in vivo analyses can be attributed to the presence of isoflavonoids with estrogen-like activity in this plant.
PubMed: 35392504
DOI: 10.1155/2022/7865015 -
Molecular Pharmaceutics Dec 2010The synergistic activity between nitric oxide (NO) released from diazeniumdiolate-modified proline (PROLI/NO) and silver(I) sulfadiazine (AgSD) was evaluated against...
The synergistic activity between nitric oxide (NO) released from diazeniumdiolate-modified proline (PROLI/NO) and silver(I) sulfadiazine (AgSD) was evaluated against Escherichia coli, Enterococcus faecalis, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus aureus and Staphylococcus epidermidis using a modified broth microdilution technique and a checkerboard-type assay. The combination of NO and AgSD was defined as synergistic when the fractional bactericidal concentration (FBC) was calculated to be <0.5. Gram-negative species were generally more susceptible to the individual antimicrobial agents than the Gram-positive bacteria, while Gram-positive bacteria were more susceptible to combination therapy. The in vitro synergistic activity of AgSD and NO observed against a range of pathogens strongly supports future investigation of this therapeutic combination, particularly for its potential use in the treatment of burns and chronic wounds.
Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Gram-Negative Bacteria; Gram-Positive Bacteria; Microbial Sensitivity Tests; Nitric Oxide; Silver Sulfadiazine
PubMed: 20939612
DOI: 10.1021/mp100248e