摘要:Poor wound healing remains a critical problem in our daily practice of surgery, exerting a heavy toll on our patients as well as on the health care system. In susceptible individuals, scars can become raised, reddish, and rigid, may cause itching and pain, and might even lead to serious cosmetic and functional problems. Hypertrophic scars do not occur spontaneously in animals, which explains the lack of experimental models for the study of pathologic scar modulation. We present the results of three clinical comparative prospective studies that we have conducted. In the first study, secondary healing and cosmetic appearance following healing of partial thickness skin graft donor sites under dry (semi-open Sofra-Tulle dressing) and moist (moist exposed burn ointment, MEBO) was assessed. In the second study, healing of the donor sites was evaluated following treatment with Tegaderm or MEBO, two different types of moisture-retentive dressings. In the third study, 3 comparable groups of primarily healed wounds were evaluated. One group was treated by topical antibiotic ointment, the second group was treated by Moist Exposed Burn Ointment (MEBO), and the third group did not receive any topical treatment. In the second study, secondary healing of partial thickness skin graft donor sites was evaluated following treatment with Tegaderm or MEBO, two different types of moisture-retentive dressings. In the second and third studies, healed wounds were evaluated with the quantitative scale for scar assessment described by Beausang et al. [1] Statistical analysis revealed that for both types of wound healing, scar quality was significantly superior in those wounds treated with MEBO.
摘要:Cosmetically unacceptable pigmentation changes and hypertrophic scarring often complicate split thickness skin graft (STSG) donor sites. In fact, patients often ask about other alternatives when confronted with the need to harvest STSG, particularly because they fear additional disfigurement. Because recent evidence suggests that a moist environment promotes more optimal healing, we conducted a limited controlled and comparative study to assess the effect of a newly introduced burn ointment MEBO (Moist Exposed Burn Ointment) (Julphar Gulf Pharmaceutical Industries, Ras Al-Khaimah, UAE) on re-epithelialization and healing of STSG donor sites as compared with the conventional Sofra-Tulle semi-open dressing (Roussel Laboratories Ltd., Uxbridge, England). We observed that MEBO treated areas were completely reepithelialized within 5 to 6 days while conventionally treated areas required 10 to 12 days to heal.
摘要:The present study aimed to compare between the use of platelet rich fibrin membrane (PRFM) and MEBO scar ointment for cutaneous wound healing as a model treatment. For this reason, forty two local breed rabbits have been divided into four groups, the first three groups were subjected to full thickness skin wound using biopsy punch instrument (diameter 8 mm) on the dorsal thoracic side. Rabbits in the first group leaved without treatment, while in the second group we planted the PRFM in biopsy site, the third group treated with MEBO scarointment. Wound healing process was observed grossly and microscopically at day 3, 7, 10 and 12 post operation.All groups showed normal healing process with competitive advantage to PRFM and MEBO groups respectively compared with untreated group, PRFM was better than the MEBO group, the advantage characterized by less inflammatory reaction, fast reepitheliazation, granulation tissue formation, fibroplasias, and angiogenesis.
摘要:Objective: Many topicals claim an efficacious role in skin scar management with limited evidence. Our aim is to present a clear format for functional testing of a skin scarring ointment, using noninvasive and invasive measurements, categorizing findings under the physiological, structural, and mechanical parameters of a scar., Approach: A double-blinded, randomized volunteer research study of 45 subjects receiving an ointment composing of natural ingredients against a widely used antiscarring topical used as a positive control with temporal sequential punch biopsies (up to 16 weeks) was evaluated using noninvasive quantitative devices and validated by gene and protein studies., Results: Outcome measures included physiological, mechanical, and structural features of scars. Significant non-invasive findings included an increase in skin hydration (p?<?0.05) at week (W) 4, 8, and 12, and elasticity (W16; p?=?0.009). These findings were validated by immunohistochemistry (IHC) and quantitative real-time PCR (qRT-PCR). Hyaluronic acid IHC (W4 p?=?0.014, W12 p?=?0.034, and W16 p?=?0.042), qRT-PCR (W16 p?=?0.049); Collagen I (W16 p?=?0.034, and 0.049) IHC and qRT-PCR, respectively. Collagen III qRT-PCR (W12 p?=?0.035, and W16 p?=?0.32); elastin IHC (W12 p?=?0.044); and fibronectin IHC (W4 p?=?0.009, W12 p?=?0.038, and W16 p = 0.026)., Innovation: Utilizing this model allows for quantitative, objective evaluation of any topical, where previously there has been a paucity of relevant methods to evaluate their effect., Conclusions: The positive effect of a topical formulation with an unknown mechanism of action on early cutaneous scar maturation over progressive sequential time points is now evidenced using noninvasive and invasive techniques with the findings categorized on the basis of scarring parameters.