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Measurements in wound healing with observations on the effects of topical agents on full thickness dermal incised
D Theunissen1, B Seymour2, M Forder2
1Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa.
Introduction:
A multitude of topical wound treatments are used today. Although it is well established that the micro-environment of healing wounds can be altered to improve healing, it is difficult to measure the subtle differences in outcome where therapies are compared.
Method:
We compared wound healing properties between four different topical agents in surgically incised wounds in a pig model. The four topical agents, 5% Povidone-Iodine cream, 1% Silver-Sulphadiazine, 2% Mupirocin, and 1% Silver-Sulphadiazine plus 1mg/100g recombinant-human epithelial growth factor (EGF) were randomly assigned to four test animals each. Test agents were compared to each other and to untreated controls. We investigated existing and new methodologies of measurement of wound healing: clinical and histological visual scoring systems, immuno-histochemistry, and computerized image analysis of the wounds on days 3, 7, and 28.
Results:
All agents were found to have improved healing rates with better cellular architecture. Healing was faster, histological appearance resembled normal architecture sooner, clinical appearance improved, mitotic activity was stimulated and more collagen was deposited in comparison to the wounds with no agents. EGF-treated wounds showed an increased rate of epithelisation, but the rate of healing did not correlate well with evaluation of cosmetic outcome.
Conclusion:
Topical agents improve all aspects of wound healing. The addition of a human recombinant EGF to Silver-Sulphadiazine increases epithelial growth and amounts of collagen in the regenerating wounds at day 7.
Insights
Topical wound treatments accelerate healing and improve tissue regeneration. Recombinant-human epithelial growth factor (EGF) combined with Silver-Sulphadiazine enhanced epithelial growth and collagen deposition in healing wounds.
Area of Science:
- Wound healing research
- Regenerative medicine
- Dermatology
Background:
- Numerous topical wound treatments exist, but subtle differences in efficacy are hard to measure.
- Optimizing the wound micro-environment is key to improving healing outcomes.
Purpose of the Study:
- To compare the wound healing properties of four topical agents.
- To evaluate existing and novel measurement methodologies for wound healing.
Main Methods:
- Surgically incised wounds in a pig model were treated with Povidone-Iodine, Silver-Sulphadiazine, Mupirocin, or Silver-Sulphadiazine plus recombinant-human epithelial growth factor (EGF).
- Wound healing was assessed using clinical and histological scoring, immuno-histochemistry, and computerized image analysis on days 3, 7, and 28.
Main Results:
- All tested topical agents improved healing rates, cellular architecture, and collagen deposition compared to controls.
- EGF-treated wounds demonstrated increased epithelialization.
- Healing rate did not strongly correlate with cosmetic outcome assessment.
Conclusions:
- Topical agents significantly enhance all aspects of wound healing.
- Combining Silver-Sulphadiazine with recombinant-human EGF promotes epithelial growth and collagen deposition in regenerating wounds.
