A Comparison of Chitosan Gel and St. John’s Wort Oil in Second-Degree Burns: An Experimental Study
AbstractBackground and Aim: Hypericum perforatum L. (HP) and chitosan are materials that are abundant in nature with anti-inflammatory, analgesic, and antibiotic properties. The present study aimed to examine the effects of these two materials on burn injuries. Materials and Methods: Twenty-one rats were divided into three groups, and burn injuries were experimentally created. Macroscopic healing of the wounds was evaluated by drawing the wound borders on transparent acetates once a week. At the end of four weeks, all the animals were sacrificed, and histopathological examinations were performed. The intact dorsum skin of the animals killed was excised to create the control group. A total of four groups were created, i.e. control, saline, St. John’s Wort Oil (SJWO), and chitosan gel group, respectively. The results were compared statistically. Results: At the end of the third week, the maximum reduction was observed in the SJWO group in the macroscopic examination (p<0.05). In histopathological examinations, dermal inflammation (Chi-square test, p<0.05) and epidermis thickness (Mann-Whitney U, p<0.05) were found to have the highest levels in the chitosan group. Conclusion: All the preparations used in this study to treat burn injuries were effective, and the wounds improved compared to the initial state. SJWO was determined to provide the best healing of the burns. Long-term use of chitosan gel did not positively affect, with both macroscopic and histopathological findings showing that it delayed the healing of wounds compared to saline and SJWO.
Lyles JT, Kim A, Nelson K, Bullard-Roberts AL, Hajdari A, Mustafa B, et al. The chemical and antibacterial evaluation of St. John’s Wort oil macerates used in Kosovar traditional medicine. Front Microbiol. 2017;8:1–19.
Saddiqe Z, Naeem I, Maimoona A. A review of the antibacterial activity of Hypericum perforatum L. J Ethnopharmacol. 2010;131:511–21.
Dai T, Tanaka M, Huang YY, Hamblin MR. Chitosan preparations for wounds and burns: Antimicrobial and wound-healing effects. Expert Rev Anti Infect Ther. 2011;9:857–79.
Hao JY, Mi FL, Shyu SS, Wu YB, Schoung JY, Tsai YH, et al. Control of wound infections using a bilayer chitosan wound dressing with sustainable antibiotic delivery. J Biomed Mater Res. 2002;59:438–49.
No HK, Young Park N, Ho Lee S, Meyers SP. Antibacterial activity of chitosans and chitosan oligomers with different molecular weights. Int J Food Microbiol. 2002;74:65–72.
Papini R. ABC of burns: Management of burn injuries of various depths. Br Med J. 2004;329(7458):158–60.
Sayar H, Gergerlioglu N, Seringec N, Ozturk P, Bulbuloglu E, Karabay G. Comparison of efficacy of topical phenytoin with hypericin in second-degree burn wound healing: an experimental study in rats. Med Sci Monit Basic Res. 2014;20:36–46.
Cai EZ, Ang CH, Raju A, Tan KB, Hing ECH, Loo Y, et al. Creation of consistent burn wounds: A rat model. Arch Plast Surg. 2014;41(4):317–24.
Arsić I. Preparation and Characterization of St. John’s Wort Herb Extracts Using Olive, Sunflower and Palm Oils. Acta Fac Medicae Naissensis. 2016;33(2):119–26.
Oliveira PC, Pinheiro ALB, De Castro ICV, Reis JA, Noia MP, Gurgel C, et al. Evaluation of the effects of polarized light (λ400-200 nm) on the healing of third-degree burns in induced diabetic and nondiabetic rats. Photomed Laser Surg. 2011;29:619–25.
Kurt Özkaya N, Alğan S, Akkaya H. Yanıklı Hastanın Değerlendirilmesi ve Tedavi Yaklaşımının Belirlenmesi. Ankara Med J. 2014;14:170–5.
Koltka K. Yanik Yaralanmalari: Yanik Derinligi, Fizyopatolojisi ve Yanik Çeşitleri. J Turk Soc Intens Care. 2011; 9(1):1-6
Irmak F, Kurt Yazar S, Şirvan SS, Serin M, Özağarı A, Karasoy Yeşilada A. Beneficial effects of Salvia miltiorrhiza in the healing of burn wounds: an experimental study in rats. J Plast Surg Hand Surg. 2018;52:229–33.
Vaghardoost R, Mousavi Majd SG, Tebyanian H, Babavalian H, Malaei L, Niazi M, et al. The Healing Effect of Sesame Oil, Camphor and Honey on Second Degree Burn Wounds in Rat. World J Plast Surg. 2018;7:67–71.
Azad AK, Sermsintham N, Chandrkrachang S, Stevens WF. Chitosan Membrane as a Wound-Healing Dressing: Characterization and Clinical Application. J Biomed Mater Res - Part B Appl Biomater. 2004;69:216–22.
Burkatovskaya M, Castano AP, Demidova-Rice TN, Tegos GP, Hamblin MR. Effect of chitosan acetate bandage on wound healing in infected and noninfected wounds in mice. Wound Repair Regen. 2008;16:425–31.
Alemdaroǧlu C, Deǧim Z, Çelebi N, Zor F, Öztürk S, Erdoǧan D. An investigation on burn wound healing in rats with chitosan gel formulation containing epidermal growth factor. Burns. 2006;32:319–27.
Ueno H, Yamada H, Tanaka I, Kaba N, Matsuura M, Okumura M, et al. Accelerating effects of chitosan for healing at early phase of experimental open wound in dogs. Biomaterials. 1999;20:1407–14.
Okamoto Y, Shibazaki K, Minami S, Matsuhashi A, Tanioka S, Shigemasa Y. Evaluation of chitin and chitosan on open would healing in dogs. J Vet Med Sci. 1995;57(5):851‐854.
Sano H, Ichioka S, Sekiya N. Influence of Oxygen on Wound Healing Dynamics: Assessment in a Novel Wound Mouse Model under a Variable Oxygen Environment. PLoS One. 2012;7:1–7.
Elsabee MZ, Abdou ES. Chitosan based edible films and coatings: A review. Mater Sci Eng. C 2013;33:1819–41.
Homez-Jara A, Daza LD, Aguirre DM, Muñoz JA, Solanilla JF, Váquiro HA. Characterization of chitosan edible films obtained with various polymer concentrations and drying temperatures. Int J Biol Macromol. 2018;113:1233–40.
Khouri J, Penlidis A, Moresoli C. Heterogeneous method of chitosan film preparation: Effect of multifunctional acid on film properties. J Appl Polym Sci. 2020;137:1–10.
Aliasl J, Khoshzaban F. Traditional Herbal Remedies for Burn Wound Healing in Canon of Avicenna. Jundishapur J Nat Pharm Prod. 2013;8:192–6.
Eğilmez OK, Kökten N, Ekici AID, Kalcioğlu MT, Yesilada E, Tekin M. The effect of Hypericum perforatum L. (St. John’s Wort) on prevention of myringosclerosis after myringotomy in a rat model. Int J Pediatr Otorhinolaryngol. 2015;79:1128–34.
Akay MA, Akduman M, Tataroğlu AÇ, Eraldemir C, Kum T, Vural Ç, et al. Evaluation of the efficacy of Hypericum perforatum (St. John’s wort) oil in the prevention of stricture due to esophageal corrosive burns. Esophagus. 2019;16:352–61.
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