Efeito do ultrassom e do dexapantenol na organização das fibras colágenas em lesão tegumentar / Effect of ultrasound and dexpanthenol on collagen organization in tegumentary lesions

OBJETIVO: Analisar o efeito do ultrassom (US), do dexapantenol (d-P) e da associação dos tratamentos (US+d-P) na organização de fibras colágenas na lesão tegumentar em ratos por meio da análise da birrefringência. MÉTODOS: Foram utilizados 50 ratos Wistar, anestesiados com Thionembutal Sódico (50mg/Kg), dos quais foi retirado 1cm² de pele da região dorsal, divididos em cinco grupos: controle (C), gel (G), US (3 MHz, 0,1 W/cm², 1 minuto, modo contínuo), d-P (10 por cento) e US+d-P. Após sete e 14 dias de tratamento diário, foram removidos segmentos dessas áreas e obtidos cortes de 6µm de espessura que, posteriormente, foram corados em Picrosirius. Os cortes foram observados em microscopia de polarização utilizando um software responsável pela medida de birrefringência das fibras colágenas (KS400 2.0 - Kontrol Eletronics). As médias das áreas birrefringentes (µm²) de cada grupo foram submetidas à análise de variância pela ANOVA, seguida do teste de Tukey (p<0,05). RESULTADOS: A média de área birrefringente do grupo US+d-P (1586,43±162,14) foi maior (p<0,001) que a dos grupos experimentais (C: 139,36±35,35, US: 317,55±129,9 e d-P: 192,41±36,57) no 7º dia de tratamento, indicando uma aceleração na síntese e organização das fibras colágenas na região lesionada. No 14º dia de tratamento, os grupos US+d-P (2858,47±510,17), US (1779,94±482,78) e d-P (2546,88±304,45) apresentaram área birrefringente maior que a do grupo C, porém não diferiram entre si. CONCLUSÃO: A associação dos tratamentos (US+d-P) acelerou a síntese e a organização das fibras colágenas apenas no estágio inicial de reparo tegumentar.

OBJECTIVE: To analyze the effect of ultrasound (US), dexpanthenol (d-P) and a combination of these treatments (US+d-P) on collagen fiber organization in tegumentary lesions in rats by birefringence analysis. METHODS: Wistar rats (50) were anesthetized (Thionembutal - Sodic = 50mg/Kg), 1cm² of dorsal region skin was removed, and the animals were divided into five groups: control (C), gel (G), US (3 MHz, 0.1 W/cm2, 1 minute, continuous), d-P (10 percent) and US+d-P. After daily treatment for 7 and 14 days, 6µm thick sections of lesioned areas were stained in picrosirius and measurements of the collagen birefringent area (µm²) were obtained using polarized light microscopy (Zeiss Axiolab-ZEISS- Germany) with histological image analysis software (KS 400 2.0 - Kontrol Eletronics, Munique, Germany). The means were compared by ANOVA followed by the Tukey test (p<0.05). RESULTS: The US+d-P group showed a significantly greater (p<0.001) birefringent area (1586.43±162.14) than the other experimental groups: C (139.36±35.35), US (317.55±129.9) and d-P (192.41±3657) by the 7th day of treatment, indicating acceleration of the wound healing process. By the 14th day of treatment, the US+d-P, US and d-P groups presented greater birefringence than the control group, but did not differ from each other. CONCLUSION: The combination of treatments (US+d-P) accelerated collagen fiber synthesis and organization in the early stages of cutaneous repair.

Comparison on the efficacy of dexpanthenol in sea water and saline in postoperative endoscopic sinus surgery.

OBJECTIVE: To compare the efficacy of dexpanthenol spray and saline irrigation in the postoperative care of sinusitis patients following endoscopic sinus surgery (ESS). MATERIAL AND METHOD: One hundred twenty eight sinusitis patients undergoing ESS were randomly allocated to receive dexpanthenol spray (Mar plus) or saline irrigation twice a day for 4 weeks after the operation. Total nasal symptom score, crusting, infection, compliance, and patient satisfaction were evaluated at 1, 2-3, 4-6, and 12 weeks. Mucociliary clearance was assessed with the saccharin test before ESS and at the last visit. One hundred ten patients remained at the present study termination. Chi-square test and Mann-Whitney U test were employed. RESULTS: Total nasal symptom score, mucociliary clearance, and infection improved in both groups after the operation. The dexpanthenol group resulted in a better mucociliary clearance than saline irrigation (9.93 +/- 6.04 vs. 12.38 +/- 9.32 min, p = 0.43). Saline irrigation resulted in a greater reduction of post nasal drip than dexpanthenol at the first visit (74% vs. 87%, p = 0.04). Compliance and patient satisfaction were comparable. CONCLUSION: The efficacy of dexpanthenol was comparable to nasal saline irrigation in the postoperative care of sinusitis patients following endoscopic sinus surgery. Dexpanthenol is an alternative treatment, which may be useful in young children and complicated cases.

Comparison of dexpanthenol and zinc oxide ointment with ointment base in the treatment of irritant diaper dermatitis from diarrhea: a multicenter study.

BACKGROUND: Severity of irritant diaper dermatitis (IDD) from diarrhea varies from patient to patient depending on the nature of feces and the number of bowel movements. The purpose of the present study was to compare the effectiveness of dexpanthenol and zinc oxide ointment with ointment base in the treatment of irritant diaper dermatitis from acute diarrhea in children by measuring transepidermal water loss (TEWL). MATERIAL AND METHOD: Forty-six children with diarrhea were prospectively, block randomized, investigator-blinded to receive dexpanthenol and zinc oxide ointment on one side and ointment base on the other side. TEWL was measured before and on days 1, 3, and 7 of treatment together with the assessment of severity score. The efficacy of treatment was defined by complete clearance of the lesion. RESULTS: TEWL in the treated and control side was not different before the application of the topical medication. In the present study, the efficacy of 5% dexpanthenol and zinc oxide ointment on D3 was 39% (18from 46 patients) compared to 32% in the ointment base side. On D7, the efficacy of the treated side was 58.7% and the ointment base side was 56%. The patients who still had skin lesions were those who had prolonged diarrhea. On the treated side, the mean of TEWL was lower than the control side on DI (p = 0.18) and had significant improvement on D3 (p = 0. 002). At the end of the present study, TEWL on the treated side was less than TEWL of the control side but it did not have statistical significance (p = 0.07). There was no rash or sign of abnormality on the treated side at the end of D7. CONCLUSION: In the treatment of lDD from acute diarrhea, 5% dexpanthenol and zinc oxide ointment significantly decreased TEWL in the treated side more than the ointment base on day 3 but the severity score was not significantly different on days 1, 3 and 7.