Baicalin, silver titanate, Bletilla striata polysaccharide and carboxymethyl chitosan in a porous sponge dressing for burn wound healing / 中西医结合学报

OBJECTIVE@#This study tests the efficacy of Bletilla striata polysaccharide (BSP), carboxymethyl chitosan (CMC), baicalin (BA) and silver titanate (ST) in a wound dressings to fight infection, promote healing and provide superior biocompatibility.@*METHODS@#The antibacterial activity of BA and ST was evaluated in vitro using the inhibition zone method. BA/ST/BSP/CMC porous sponge dressings were prepared and characterized. The biocompatibility of BA/ST/BSP/CMC was assessed using the cell counting kit-8 assay. The therapeutic effect of BA/ST/BSP/CMC was further investigated using the dorsal skin burn model in Sprague-Dawley rats.@*RESULTS@#The wound dressing had good antibacterial activity against Escherichia coli and Staphylococcus aureus through BA and ST, while the combination of BSP and CMC played an important role in promoting wound healing. The BA/ST/BSP/CMC porous sponge dressings were prepared using a freeze-drying method with the concentrations of BA and ST at 20 and 0.83 mg/mL, respectively, and the optimal ratio of 5% BSP to 4% CMC was 1:3. The average porosity, water absorption and air permeability of BA/ST/BSP/CMC porous sponge dressings were measured to be 90.43%, 746.1% and 66.60%, respectively. After treatment for 3 and 7 days, the healing rates of the BA/ST/BSP/CMC group and BA/BSP/CMC group were significantly higher than those of the normal saline (NS) group and silver sulfadiazine (SSD) group (P < 0.05). Interleukin-1β expression in the BA/ST/BSP/CMC group at 1 and 3 days was significantly lower than that in the other three groups (P < 0.05). After being treated for 3 days, vascular endothelial growth factor expression in the BA/BSP/CMC group and BA/ST/BSP/CMC group was significantly higher than that in the NS group and SSD group (P < 0.05). Inspection of histological sections showed that the BA/ST/BSP/CMC group and BA/BSP/CMC group began to develop scabbing and peeling of damaged skin after 3 days of treatment, indicating accelerated healing relative to the NS group and SSD group.@*CONCLUSION@#The optimized concentration of BA/ST/BSP/CMC dressing was as follows: 6 mg BSP, 14.4 mg CMC, 0.5 mg ST and 12 mg BA. The BA/ST/BSP/CMC dressing, containing antibacterial constituents, was non-cytotoxic and effective in accelerating the healing of burn wounds, making it a promising candidate for wound healing. Please cite this article as: Gong YR, Zhang C, Xiang X, Wang ZB, Wang YQ, Su YH, Zhang HQ. Baicalin, silver titanate, Bletilla striata polysaccharide and carboxymethyl chitosan in a porous sponge dressing for burn wound healing. J Integr Med. 2023; 21(5): 487-495.

Development and Characterization of a Hydrogel Containing Silver Sulfadiazine for Antimicrobial Topical Applications. Part II: Stability, Cytotoxicity and Silver Release Patterns

Abstract Hydrogels are interesting for use in the treatment of topical wounds due to their virtually zero toxicity, and capacity for extended release of pharmaceuticals. Silver sulfadiazine (SSDZ) is the drug of choice in the treatment of skin burns. The aim of the study was to determine cytotoxicity, antimicrobial activity and stability of a PVA hydrogel with integrated silver sulfadiazine. SSDZ-hydrogels were prepared using 10% (w/w) PVA (either 89% or 99% hydrolyzed) and 1% (w/w) silver sulfadiazine. Cellular viability was assessed via MTS assays, antimicrobial activity via disk-diffusion and accelerated stability tests were carried out with analysis at 0, 30, 60, 90 and 180 days of storage at 40 ± 2 °C and a relative humidity of 75 ± 5%. The parameters evaluated included organoleptic characteristics, moisture, swelling ability, mechanical strength, FTIR, XRD, TGA and DSC, and silver release patterns via XRD and potentiometry. Cell viability tests indicated some cytotoxicity, although within acceptable levels. After 90 days of storage, SSDZ hydrogel samples exhibited a brown coloration, probably due to the formation of Ag or Ag2O nanoparticles. The SSDZ-loaded hydrogels suffered visual and physical changes; however, these changes did not compromise its use as occlusive wound dressings or its antimicrobial properties.

Tissue healing efficacy in burn patients treated with 1% silver sulfadiazine versus other treatments: a systematic review and meta-analysis of randomized controlled trials

Abstract This study aims to evaluate tissue healing efficacy in burn patients treated with 1% silver sulfadiazine versus other treatments. This is a systematic literature review and meta-analysis of randomized clinical trials performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and PICO strategy, registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42017081057. The review found 71 studies in MEDLINE/Pubmed, 1 in Clinical Trials, 19 in the Cochrane Library, and 4 in LILACS in five manual searches. Of these, 81 studies were pre-selected. After independent analysis by two reviewers, only 11 studies met the inclusion criteria for the review. All studies (n = 11) using alternative treatments to silver sulfadiazine were shown to be superior in the mean time for complete wound healing, with statistically significant differences between experimental and control groups (p <0.00001); mean difference (- 4.26), 95% CI [- 5.96, - 2.56].

Comparison of the healing effects of topical phenytoin, estrogen and silver sulfadiazine on skin wounds in male rats

Shortening of the duration of wound healing is an attractive subject for investigators in recent years. In this study, the effects of topical phenytoin, silver sulfadiazine, estrogen and their combination on wound healing were evaluated. This experimental study was accomplished on 30 male albino rats, which had an approximate weight from 110 to 150 grams and were kept under standard conditions. A skin wound with a diameter of 20 mm was cut on the back of neck of each rat. Animals were divided into 6 groups and each animal was carried in a special isolated cage. For the first group, no drugs were used on the wounds. Topical 1% silver sulfadiazine cream was used in the second group.Third group recevied topical 1% phenytoin ointment. Wounds in fourth group were treated with 0.06% estrogen cream. Wounds in the fifth group were treated with the combination of 1% silver sulfadiazine and 1% phenytoin creams and wounds in the sixth group were treated with combination of 1% silver sulfadiazine cream and the estrogen cream. Surgery day was considered as the first day and animals were followed up for 28 days. Wound surface area was assessed on each animal and the healing rate was assessed on days: 1, 3, 7, 14, 21.The most effective treatments were topical estrogen cream alone and topical phenytoin-silver sulfadiazine combination. Combination of topical estrogen and other drugs and phenytoin alone showed less acceleration on wound healing. Although application of topical estrogen cream alone or combination of phenytoin and silver sulfadiazine creams showed more healing effect, but there was no significant difference on the wound healing of animals that were treated by these products. Further studies on human wounds with larger sample size is suggested

Estudo experimental da eficácia da sulfadiazina de prata a 1 por cento no tratamento da ceratite por Fusarium solani / Experimental study of silver sulphadiazine 1 per cents in the treatment of Fusarium solani

Foi realizado estudo experimental com 21 coelhos para avaliar a eficácia da sulfadiazina de prata a 1 por cento no tratamento da ceratite por Fusarium solani. Os animais foram divididos em 3 grupos tratados com sulfadiazina de prata a 1 por cento (grupo S); com veículo (grupo V) e sem tratamento (grupo C). Todos os animais apresentaram cura clínica, com tempo médio igual à 17 dias no grupo C; 17 dias no grupo V e 20 dias no grupo S. A secreçäo ocular esteve presente por um período médio de 8 dias no grupo C; 7 dias no grupo V e 5 dias no grupo S. A conjuntivite esteve presente em todos os animais desaparecendo em 13 dias no grupo C; 14 no "V" e 12 no "S". Observou-se melhora da doença epitelial em 5 dias, 4 e 3 dias, respectivamente, nos grupos C, V e S. A formaçäo de abscesso ocorreu em todos os animais, tendo desaparecido mais precocemente no grupo S. A vascularizaçäo corneana foi maior nos animais tratados com sulfadiazina de prata. Näo houve diferença estatisticamente significante entre os achados. O estudo histopatológico mostrou processo inflamatório crônico, vascularizaçäo e fibrose localizada. Conclui-se que a sulfadiazina de prata a 1 por cento, usada topicamente mostrou-se ineficaz no tratamento das ceratites por F. solani em coelhos