Topical Bixa orellana for Postoperative Wound Healing: A Prospective Randomized Controlled Trial

Area of Science:

• Dermatology
• Surgical Outcomes
• Wound Healing

Background:

• Scar formation is a common concern after surgery, with limited evidence on topical treatments for foot and ankle procedures.
• Bixa orellana (Urucu) is a plant-based ingredient with potential therapeutic properties.

Purpose of the Study:

• To evaluate the efficacy of Bixa orellana (Urucu) ointment in managing scars from elective foot and ankle surgery.
• To compare Urucu ointment's effects against a conventional control ointment for postoperative wound care.

Main Methods:

• A prospective, single-center, randomized controlled trial involving adult patients undergoing elective foot and ankle surgery.
• Participants received either Urucu ointment or a control ointment for 4 weeks, starting 2 weeks postoperatively.
• The primary outcome measure was the Patient and Observer Scar Assessment Scale (POSAS) at 6 weeks.

Main Results:

• Urucu ointment significantly improved observer-assessed scar characteristics, including vascularity, pigmentation, thickness, relief, and pliability.
• Both observers and patients reported more favorable scar appearance with Urucu, indicated by lower overall POSAS scores (2.56 vs. 3.33 for observers; 3.70 vs. 4.80 for patients).
• No significant differences were observed in antibiotic use, delayed healing, or need for reoperation; localized reactions occurred in two patients.

Conclusions:

• Topical Urucu ointment shows potential for early scar improvement in foot and ankle surgery patients, particularly regarding pigmentation and pliability.
• Findings suggest Urucu may help scars resemble normal skin more closely.
• Further research with larger sample sizes and longer follow-up is warranted due to the study's limitations.