A Comparative Study of Honey and Phenytoin Dressings for Chronic Wounds.
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ABSTRACT:
SUBMITTER: Dubhashi SP
PROVIDER: S-EPMC4775671 | biostudies-literature | 2015 Dec
REPOSITORIES: biostudies-literature
Publications
A Comparative Study of Honey and Phenytoin Dressings for Chronic Wounds.
Dubhashi Siddharth P SP Sindwani Rajat D RD
The Indian journal of surgery 20150308 Suppl 3
Chronic wounds are a common problem faced by health care professionals, both in the community and in the hospital setting. The aim of this study was to evaluate the use of honey and phenytoin with respect to the process of wound healing, eradication of infection, pain relief and hospital stay. The study included 150 patients, 3 groups of 50 each (group A, honey dressing; group B, phenytoin dressing; group C, saline dressing). The appearance of granulation tissue was faster with significant wound ...[more]
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Project description:Chronic wounds impose a substantial economic burden on healthcare systems and result in decreased productivity. Honey possesses diverse properties, rendering it a promising, cost-effective, and efficacious intervention strategy for the management of chronic wounds. However, the findings are controversial. We have presented an updated and comprehensive systematic review and meta-analysis to evaluate the efficacy and safety of honey dressings in the management of chronic wounds. Nine electronic databases were systematically searched to identify relevant studies published prior to 22 March 2024. A total of eight studies, including 906 individuals that met the inclusion criteria, were incorporated. The findings demonstrated a significant acceleration in wound healing time with honey dressings (MD = -17.13, 95% CI -26.37 to -7.89, p = 0.0003) and an increase in the percentage of wound healing (MD = 18.31, 95% CI 8.86 to 27.76, p = 0.0001). No statistically significant differences were observed in the healing rate (RR = 2.00, 95% CI 0.78 to 5.10, p = 0.15), clearance time of bacteria (MD = -11.36, 95% CI: -25.91 to 3.18, p = 0.13) and hospital stay duration. Honey may decrease the VAS score but may increase the incidence of painful discomfort during treatment. The topical application of honey is an effective therapeutic approach for managing chronic wounds, but the quality of the evidence was very low due to the quality of risk of bias, inconsistency, and publication bias, highlighting the necessity for larger-scale studies with adequately powered RCTs to ensure the safety and efficacy of honey dressings in chronic wound healing.
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Project description:Abstract Background Nowadays, a wide range of wound dressings is already commercially available. The selection of the dressing is of paramount importance as inappropriate wound management and dressing selection can delay the wound healing process. Not only can this be distressing for the patient, but it can also contribute to complications such as maceration and subsequent infection. Many researchers are targeting the design of dressings with superior properties over existing commercial dressings. However, reported results in the state-of-the-art are rarely benchmarked against commercial dressings. The aim of this study was to determine several characteristics of a large variety of the most frequently used commercial wound dressings, providing an overview for both practitioners and researchers. Methods For this comparative study, 11 frequently used commercial wound dressings were selected, representing the different types. The morphology was studied using scanning electron microscopy. The dressings were characterized in terms of swelling capacity (water, phosphate buffered saline and simulated wound fluid), moisture vapour transmission rate (MVTR) and moisture uptake capacity (via dynamic vapour sorption) as well as mechanical properties using tensile testing and texturometry. Results The selected dressings showed distinctive morphological differences (fibrous, porous and/or gel) which was reflected in the different properties. Indeed, the swelling capacities ranged between 1.5 and 23.2 g/g (water), 2.1 and 17.6 g/g (phosphate buffered saline) or 2.9 and 20.8 g/g (simulated wound fluid). The swelling capacity of the dressings in water increased even further upon freeze-drying, due to the formation of pores. The MVTR values varied between 40 and 930 g/m2/24 h. The maximal moisture uptake capacity varied between 5.8% and 105.7% at 95% relative humidity. Some commercial dressings exhibited a superior mechanical strength, due to either being hydrophobic or multi-layered. Conclusions The present work not only offers insight into a valuable toolbox of suitable wound dressing characterization techniques, but also provides an extensive landscaping of commercial dressings along with their physico-chemical properties, obtained through reproducible experimental protocols. Furthermore, it ensures appropriate benchmark values for commercial dressings in all forthcoming studies and could aid researchers with the development of novel modern wound dressings. The tested dressings either exhibited a high strength or a high swelling capacity, suggesting that there is still a strong potential in the wound dressings market for dressings that possess both.
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Project description:In this study, we report a metallogel developed based on metal-phenolic coordination of natural low-cost polyphenolic molecule and metal ions. Gelation occurs by mixing tannic acid (TA) and group (IV) titanium ions (TiIV) to form TA-TiIV gel. The TA-TiIV gel exhibits good capability to incorporate diverse metal ions by in situ co-gelation. Herein, five antimicrobial metal ions, i.e. ferric (FeIII), copper (CuII), zinc (ZnII), cobalt (CoII) and nickel (NiII) ions, were employed to include in TA-TiIV gels for developing intelligent dressings for infected wounds. The chemical and coordinative structures of TA-TiIV metallogels were characterized by UV-Vis and Fourier-transform infrared (FT-IR) spectroscopies. Cytotoxicity of antimicrobial metallogels was explored by MTT assay with NIH 3T3 fibroblasts. The release of metal ions was evaluated by inductively coupled plasma mass spectrometry (ICP-MS), indicating the different releasing profiles upon the coordinative interactions of metal ions with TA. The formation and disassembly of metallogels are sensitive to the presence of acid and an oxidizer, H2O2, which are substances spontaneously generated in infected wounds due to the metabolic activity of bacteria and the intrinsic immune response. The CuII releasing rates of TA-TiIV-CuII metallogels at different pH values of 5.5, 7.4 and 8.5 have been studied. In addition, addition of H2O2 trigger fast release of CuII as a result of oxidation of galloyl groups in TA. Consequently, the antimicrobial potency of TA-TiIV-CuII metallogels can be simultaneously activated while the wounds are infected and healing. The antimicrobial property of metallogels against Gram-negative Escherichia coli, and Gram-positive Methicillin-Resistant Staphylococcus aureus (USA300) and Staphylococcus epidermidis has been investigated by agar diffusion test. In an animal model, the TA-TiIV-CuII metallogels were applied as dressings for infected wounds, indicating faster recovery in the wound area and extremely lower amount of bacteria around the wounds, compared to TA-TiIV gels and gauze. Accordingly, the intelligent nature derived metallogels is a promising and potential materials for medical applications.
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| S-EPMC9930691 | biostudies-literature
Project description:Local administration of antiseptics is required to prevent and fight against biofilm-based infections of chronic wounds. One of the methods used for delivering antiseptics to infected wounds is the application of dressings chemisorbed with antimicrobials. Dressings made of bacterial cellulose (BC) display several features, making them suitable for such a purpose. This work aimed to compare the activity of commonly used antiseptic molecules: octenidine, polyhexanide, povidone-iodine, chlorhexidine, ethacridine lactate, and hypochlorous solutions and to evaluate their usefulness as active substances of BC dressings against 48 bacterial strains (8 species) and 6 yeast strains (1 species). A silver dressing was applied as a control material of proven antimicrobial activity. The methodology applied included the assessment of minimal inhibitory concentrations (MIC) and minimal biofilm eradication concentration (MBEC), the modified disc-diffusion method, and the modified antibiofilm dressing activity measurement (A.D.A.M.) method. While in 96-well plate-based methods (MIC and MBEC assessment), the highest antimicrobial activity was recorded for chlorhexidine, in the modified disc-diffusion method and in the modified A.D.A.M test, povidone-iodine performed the best. In an in vitro setting simulating chronic wound conditions, BC dressings chemisorbed with polyhexanide, octenidine, or povidone-iodine displayed a similar or even higher antibiofilm activity than the control dressing containing silver molecules. If translated into clinical conditions, the obtained results suggest high applicability of BC dressings chemisorbed with antiseptics to eradicate biofilm from chronic wounds.
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Project description:Chronic wounds affect ~2% of the U.S. population and increase risks of amputation and mortality. Unfortunately, treatments for such wounds are often expensive, complex, and only moderately effective. Electrotherapy represents a cost-effective treatment; however, its reliance on bulky equipment limits its clinical use. Here, we introduce water-powered, electronics-free dressings (WPEDs) that offer a unique solution to this issue. The WPED performs even under harsh conditions-situations wherein many present treatments fail. It uses a flexible, biocompatible magnesium-silver/silver chloride battery and a pair of stimulation electrodes; upon the addition of water, the battery creates a radial electric field. Experiments in diabetic mice confirm the WPED's ability to accelerate wound closure and promote healing by increasing epidermal thickness, modulating inflammation, and promoting angiogenesis. Across preclinical wound models, the WPED-treated group heals faster than the control with wound closure rates comparable to treatments requiring expensive biologics and/or complex electronics. The results demonstrate the WPED's potential as an effective and more practical wound treatment dressing.
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