Comparison Between Topical Sucralfate, Topical Platelet-Rich Plasma and Topical Ozonated Virgin Coconut Oil to Enhance Wound Healing in Diabetic Ulcer Mice model

Renni Yuniati, Matthew Brian Khrisna, Farmaditya Eka Putra, Kristophorus Heri Nugroho Hario Seno, Tri Nur Kristina

DOI: http://dx.doi.org/10.5138/09750185.2466

Abstract


Diabetic ulcer is a serious complication of diabetes mellitus which can lead to further morbidity. Sucralfate, Platelet-rich plasma (PRP) and ozonated virgin coconut oil (VCO) has been shown to provide good clinical outcomes in chronic ulcer healing. This study compares the effectiveness of topical sucralfate, topical PRP and topical ozonated VCO therapy for diabetic ulcer treatment in Wistar mice by observing wound length and vascular endothelial growth factor (VEGF). Ninety Wistar mice with full-thickness ulcer model on the back were divided into 5 groups. Four groups of mice were receiving diabetic induction using streptozotocin injection and were allocated as topical sucralfate (TS), topical PRP (TP), and topical ozonated VCO (TO) group. The remaining diabetic-positive mice were allocated as the diabetic-positive control group (PC) which received standard therapy, and the other non-diabetic mice were allocated as the diabetic-negative control group (NC) which did not receive any therapy. Topical ozonated VCO enhances the wound healing process better with the greatest wound reduction area and highest VEGF expression compared to topical sucralfate and topical PRP. Topical ozonated VCO can potentially accelerate wound healing in diabetic ulcers better than topical sucralfate and topical PRP. 


Keywords


diabetes, sucralfate, PRP, ozone, VCO, wound healing

References


Tran TD-X, Le PT-B, Pham P Van. Diabetic foot ulcer treatment by activated platelet rich plasma: a clinical study. Biomed Res Ther. 2014;1(02):37-42. 2. Alexiadou K, Doupis J. Management of diabetic foot ulcers. Diabetes Ther. 2012;3(1):4. doi:10.1007/s13300-012-0004-9 3. Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y. Global Epidemiology of Diabetic Foot Ulceration: A Systematic Review and Meta-analysis. Ann Med. 2017;49(2):106-116. doi:10.1080/07853890.2016.1231932 4. Oguntibeju OYBE-OO. Diabetes Mellitus in Developing Countries and Case Series. In: Rijeka: IntechOpen; 2013:Ch. 8. doi:10.5772/50658 5. Arosi I, Hiner G, Rajbhandari S. Pathogenesis and Treatment of Callus in the Diabetic Foot. Curr Diabetes Rev. 2016;12(3):179-183. doi:10.2174/1573399811666150609160219 6. Yazdanpanah L, Shahbazian H, Nazari I, et al. Risk factors associated with diabetic foot ulcer-free survival in patients with diabetes. Diabetes Metab Syndr Clin Res Rev. 2018;12(6):1039-1043. doi:10.1016/j.dsx.2018.06.020 7. Alvarsson A, Sandgren B, Wendel C, Alvarsson M, Brismar K. A retrospective analysis of amputation rates in diabetic patients: Can lower extremity amputations be further prevented? Cardiovasc Diabetol. 2012;11. doi:10.1186/1475-2840-11-18 8. Bakker K, Apelqvist J, Lipsky BA, Van Netten JJ, Schaper NC. The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: Development of an evidence-based global consensus. Diabetes Metab Res Rev. 2016;32(November 2017):2-6. doi:10.1002/dmrr.2694 9. Lipsky BA, Berendt AR, Cornia PB, et al. 2012 infectious diseases society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012;54(12):132-173. doi:10.1093/cid/cis346 10. Lavery LA, Davis KE, Berriman SJ, et al. WHS guidelines update: Diabetic foot ulcer treatment guidelines. Wound Repair Regen. 2016;24(1):112-126. doi:10.1111/wrr.12391 11. Estelle E, Mathioudakis N. Update on management of diabetic foot ulcers Estelle. Physiol Behav. 2017;176(3):139-148. doi:10.1016/j.physbeh.2017.03.040 12. Sørensen MLB, Jansen RB, Wilbek Fabricius T, Jørgensen B, Svendsen OL. Healing of Diabetic Foot Ulcers in Patients Treated at the Copenhagen Wound Healing Center in 1999/2000 and in 2011/2012. J Diabetes Res. 2019. doi:10.1155/2019/6429575 13. Nagalakshmi G, Amalan AJ, Anandan H. Clinical Study of Comparision Between Efficacy of Topical Sucralfate and Conventional Dressing in the Management of Diabetic Ulcer. Int J Sci Study. 2017;236(3):236-236. doi:10.17354/ijss/2017/302 14. Velayutham S, Velayutham P. A comparative study on the efficacy of platelet rich plasma vs conventional wound dressing in diabetic foot ulcers. Int Surg J. 2019;6(5):1-4. doi:10.18203/2349-2902.isj20191484 15. Masuelli L, Tumino G, Turriziani M, Modesti A, Bei R. Topical Use of Sucralfate in Epithelial Wound Healing: Clinical Evidence and Molecular Mechanisms of Action. Recent Pat Inflamm Allergy Drug Discov. 2010;4(1):25-36. doi:10.2174/187221310789895649 16. Hidajat D, Malik DA, Buditjahjono S. Platelet-Rich Plasma Dalam Dermatologi. Mdvi. 2012;39(4):176-185. 17. Werner S, Grose R. Regulation of wound healing by growth factors and cytokines. Physiol Rev. 2003:835-870. doi:10.1152/physrev.2003.83.3.835 18. Varma SR, Sivaprakasam TO, Arumugam I, et al. In vitro anti-inflammatory and skin protective properties of Virgin coconut oil. J Tradit Complement Med. 2019;9(1):5-14. doi:10.1016/j.jtcme.2017.06.012 19. Elvis AM, Ekta JS. Ozone therapy: A clinical review. J Nat Sci Biol Med. 2011;2(1):66-70. doi:10.4103/0976-9668.82319 20. Borges GÁ, Elias ST, da Silva SMM, et al. In vitro evaluation of wound healing and antimicrobial potential of ozone therapy. J Cranio-Maxillofacial Surg. 2017;45(3):364-370. doi:10.1016/j.jcms.2017.01.005 21. Saini R. Ozone therapy in dentistry: A strategic review. J Nat Sci Biol Med. 2011;2(2):151-153. doi:10.4103/0976-9668.92318 22. Travagli V, Zanardi I, Valacchi G, Bocci V. Ozone and ozonated oils in skin diseases: a review. Mediators Inflamm. 2010;2010:610418. doi:10.1155/2010/610418 23. Ghasemi A, Khalifi S, Jedi S. Streptozotocin-nicotinamide-induced rat model of type 2 diabetes (review). Acta Physiol Hung. 2014:408-420. doi:10.1556/APhysiol.101.2014.4.2 24. Harms PG, Ojeda SR. A rapid and simple procedure for chronic cannulation of the rat jugular vein. J Appl Physiol. 1974;36(3):391-392. doi:10.1152/jappl.1974.36.3.391 25. Messora MR, Nagata MJH, Furlaneto FAC, et al. A standardized research protocol for platelet-rich plasma (PRP) preparation in rats. RSBO. 2011;8(3):299-304. 26. NAGATA M, Messora M, Deliberador T, et al. Análise da eficiência do protocolo de dupla centrifugação para o preparo do plasma rico em plaquetas (PRP) - estudo experimental em coelhos. RSBO Rev Sul-Brasileira Odontol. 2009;6:291-296. 27. Puryadi, Nur M, Sumariyah, Restiwijaya M, Niyomukiza JB. Reactor Study of Double Dielectric Barrier Discharge (DDBD) Plasma for Ozonation Olive Oil. Int J Allied Med Sci Clin Res. 2019;7(1):1-5. 28. Ibrahim AH, Li H, Al-Rawi SS, et al. Angiogenic and wound healing potency of fermented virgin coconut oil: in vitro and in vivo studies. Am J Transl Res. 2017;9(11):4936-4944. 29. Izadi M, Jafari NJ, Hosseini MS, Saafaat O. Therapeutic effects of ozone in patients with diabetic foot ulcers: Review of the literature. Cochrane Database Syst Rev. 2017;28(18):7846-7850. 30. Liu J, Zhang P, Tian J, et al. Ozone therapy for treating foot ulcers in people with diabetes. Cochrane Database Syst Rev. 2015;(10):CD008474. doi:10.1002/14651858.CD008474.pub2 31. Valacchi G, Bocci V. Studies on the biological effects of ozone: 11. Release of factors from human endothelial cells. Mediators Inflamm. 2000;9(6):271-276. doi:10.1080/09629350020027573 32. Bocci VA, Zanardi I, Travagli V. Ozone acting on human blood yields a hormetic dose-response relationship. J Transl Med. 2011;9:66. doi:10.1186/1479-5876-9-66 33. Martínez-Sánchez G, Al-Dalain SM, Menéndez S, et al. Therapeutic efficacy of ozone in patients with diabetic foot. Eur J Pharmacol. 2005;523(1-3):151-161. doi:10.1016/J.EJPHAR.2005.08.020 34. Oliveira, Juliana TC De. Systematic Literature Review about the therapeutic use of the ozone in wounds [dissertation]. 2007. 35. Liu ZJ, Velazquez OC. Angiogenesis in wound healing. In: Encyclopedia of the Eye. ; 2010:219-229. doi:10.1016/B978-0-12-374203-2.00124-X 36. Gonzalez AC de O, Costa TF, Andrade Z de A, Medrado ARAP. Wound healing - A literature review. An Bras Dermatol. 2016;91(5):614-620. doi:10.1590/abd1806-4841.20164741 37. Hatazawa R, Tanaka A, Tanigami M, et al. Cyclooxygenase-2/prostaglandin E 2 accelerates the healing of gastric ulcers via EP 4 receptors. Am J Physiol - Gastrointest Liver Physiol. 2007;293(4). doi:10.1152/ajpgi.00131.2007 38. Patel S, Srivastava S, Singh MR, Singh D. Mechanistic insight into diabetic wounds: Pathogenesis, molecular targets and treatment strategies to pace wound healing. Biomed Pharmacother. 2019;112:108615. doi:10.1016/j.biopha.2019.108615 39. del Pino-Sedeño T, Trujillo-Martín MM, Andia I, et al. Platelet-rich plasma for the treatment of diabetic foot ulcers: A meta-analysis. Wound Repair Regen. 2019;27(2):170-182. doi:10.1111/wrr.12690 40. Lacci KM, Dardik A. Platelet-rich plasma: support for its use in wound healing. Yale J Biol Med. 2010;83(1):1-9. 41. El-Sharkawy H, Kantarci A, Deady J, et al. Platelet-Rich Plasma: Growth Factors and Pro- and Anti-Inflammatory Properties. J Periodontol. 2007;78(4):661-669. doi:10.1902/jop.2007.060302 42. Sundman EA, Cole BJ, Karas V, et al. The anti-inflammatory and matrix restorative mechanisms of platelet-rich plasma in osteoarthritis. Am J Sports Med. 2014;376:143-152. doi:10.1177/0363546513507766


Refbacks

  • There are currently no refbacks.
';



Copyright (c) 2021 Renni Yuniati

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                AR Journals

Street 1st, Gaytri Vihar, Pinto Park, Gwalior, M.P. India

              Copyright@arjournals.org (Design) 2009-2021

 

Follow @arjournals on Twitter