Development of an animal model to investigate optimal laparoscopic trocar site fascial closure

Background

The rate of hernia formation after closure of 10–12 mm laparoscopic trocar sites is grossly under-reported. Using an animal model, we have developed a method to assess trocar site fascial dehiscence and the strength of different methods of fascial closure.

Materials and methods

Pigs (n = 9; 17 ± 2.5 lbs) underwent placement of 12 mm Hasson trocars with pneumoperitoneum maintained for 1 h. Three closure techniques (Figure-of-eight; simple interrupted; pulley) were compared with no fascial closure and to native fascia at five randomly allocated abdominal wall midline locations. Necropsy was performed on the fourth postoperative d. Statistical comparisons of tensile strength and breaking strength based on closure type and trocar location were made using ANOVA with Tukey’s tests.

Results

The mean (SD) force (Newtons) required for fascial disruption varied significantly with closure type [Native Fascia 170 (39), Figure-of-eight 169 (31), Pulley 167 (59), Simple Interrupted 151 (27), No Closure 108 (28)]; P = 0.007. The mean force required for fascial disruption was significantly increased for Native Fascia, Figure-of-eight, and Pulley relative to No Closure (P = 0.013, P = 0.015, P = 0.023, respectively). The mean (SD) force (in Newtons) required for fascial disruption also varied significantly with location of trocar [subxiphoid 181 (43), supraumbilical 151 (23), Umbilical 146 (23), infraumbilical 168 (62), suprapubic 120 (38)]; P = 0.03. The mean force for subxiphoid location was significantly increased relative to the suprapubic location (P = 0.021).

Conclusions

We have developed a novel assessment model that reliably detects differences in fascial integrity after laparoscopic trocar placement and closure. This model will allow for further testing of various trocars and closure techniques, and facilitate hernia prevention strategies.     

Bioassay-guided isolation of anti-inflammatory, antinociceptive and wound healer glycosides from the flowers of Verbascum mucronatum Lam.

Ethnopharmacological relevance

The leaves, flowers and whole aerial parts of Verbascum L. species have been used to treat respiratory problems, haemorrhoids and other types of inflammatory conditions in traditional Turkish medicine.

Aim of the study

In order to evaluate this traditional information, the anti-inflammatory, antinociceptive and wound healing activities of Verbascum mucronatum Lam. which is used as haemostatic in Turkish folk medicine were investigated.

Materials and methods

In vivo inhibitory effect of the extracts on the carrageenan-induced hind paw edema model in mice was studied for the assessment of anti-inflammatory activity. Moreover, the wound healing potential of the plant were evaluated by using in vivo wound healing experimental models, i.e. incision and excision models on mice and rats, were comparatively assessed with a reference ointment Madecassol^®. Skin samples were also evaluated histopathologically.

Results

The results of these experimental studies exhibited that Verbascum mucronatum displays anti-inflammatory, antinociceptive and wound healing activities. Through bioassay-guided fractionation and isolation procedures four iridoid glucosides, ajugol (1), aucubin (2), lasianthoside I (3), catalpol (4), two saponins, ilwensisaponin A (5) and C (6) and a phenylethanoid glycoside, verbascoside (7) were isolated and their structures were elucidated by spectral techniques. Verbascoside (7) was found to possess significant wound healing activity as well as antinociceptive and anti-inflammatory potentials, per os without inducing any apparent acute toxicity or gastric damage.

Conclusion

The experimental study revealed that Verbascum mucronatum displays remarkable antinociceptive, anti-inflammatory and wound healing activities.     

Wound healing potential of Sambucus ebulus L. leaves and isolation of an active component,quercetin 3-O-glucoside

Ethnopharmacological relevance

The leaves of Sambucus ebulus L. are used in Turkish folk medicine for treatment of high fever, rheumatic pains, snake bites and wounds.

Aim of the study

Four different solvent extracts by using n-hexane, diethyl ether, ethyl acetate and methanol were prepared from the leaves of Sambucus ebulus in order to investigate the claimed wound healing activity in vivo and isolation of active component(s) from the active extract through the bioassay-guided fractionation procedures.

Materials and methods

Linear incision and circular excision wound models on rats and mice were employed. The methanol extract was fractionated by successive chromatographic techniques. Wound healing activity of each fraction was investigated following the bioassay-guided fractionation procedures. Moreover, the tissue samples were examined histopathologically.

Results

Significant wound healing activity was observed for the ointment prepared with methanol extract at 1% concentration. The methanol extract treated groups of animals showed 84.3% contraction in circular excision model, which was close to contraction value of the reference drug Madecassol^® (100%). On the other hand, a significant increase (43.7%) in the wound tensile strength was determined with the same extract on incision wound model. Subfractions showed significant but reduced wound healing activity on both in vivo wound models. A flavonoid derivative “quercetin 3-O-glucoside” was isolated and determined as one of the active component of active final subfraction. The results of histopathological examination supported the outcome of linear incision and circular excision wound models.

Conclusion

The experimental data revealed that the methanolic extract of Sambucus ebulus leaves displayed remarkable wound healing activity.     

A novel wound healing ointment: a formulation of Hypericum perforatum oil and sage and oregano essential oils based on traditional Turkish knowledge

Aim of the study

Hypericum perforatum L. (Hypericaceae), olive oil (Oleaceae), Origanum Tourn ex L. and Salvia L. species (Lamiaceae) are used against inflammatory disorders and for healing of skin wounds in traditional Turkish medicine. A new ointment formulation was developed to provide more efficient wound healing activity. The content of the formulation was as follows; olive oil extract of flowering aerial parts of Hypericum perforatum L., olive oil, an equivalent mixture of Origanum majorana L. and Origanum minutiflorum Schwrd. et Davis essential oils (Origani aetheroleum), Salvia triloba L. essential oil. The aim of the present study is to assess the wound healing potential of this new formulation by using in vivo and in vitro models as well as histopathological methods.

Materials and methods

For the evaluation of wound healing potential of this formulation (HPP crème mit Rotöl ointment) in vivo wound healing experimental models were employed on rats and mice and the efficiency was comparatively assessed against a reference ointment Madecassol^®. Tissue sections were also evaluated histopathologically. Furthermore, the wound healing activity of each component was also investigated individually to determine the improvement in the healing capacity of the formulation.

Results

The ointments of HPP crème mit Rotöl and Hypericum perforatum L. demonstrated the highest activities on both wound models when compared to reference ointment Madecassol^®, while the other ingredients did not show any remarkable wound healing effect. However, the efficacy of the formulation was remarkably higher than the Hypericum L. ointment alone which was also confirmed by histopathological evaluation. On the other hand, the formulation did not reduce elastase activity in vitro, but inhibited the collagenase activity. HPP crème mit Rotöl also exerted bactericidal and candicidal activities.

Conclusions

The experimental studies revealed that HPP crème mit Rotöl formulation displays remarkable wound healing activity. To be acting on the different stages of wound healing process could be considered as a beneficial effect of the formulation for the treatment of wounds.     

Wound healing acceleration effect of endemic Ononis species growing in Turkey

Aim of the study

Ononis L. species have been used for healing of wounds, eczema and rheumatic complaints, against skin cancer and lesions and topically used as antiseptic and antimicrobial agent in folk medicine. In the present study, the aqueous and methanolic extracts of three endemic Ononis species growing in Turkey, including Ononis sessilifolia Bornm., Ononis basiadnata Hub.-Mor. and Ononis macrosperma Hub.-Mor. were assessed for their in vivo wound healing and anti-inflammatory activities.

Materials and methods

In vivo wound healing activities of the plants were evaluated by using linear incision and circular excision experimental models subsequently histopathological analysis. The healing potential was comparatively assessed with a reference ointment Madecassol^®, which contains 1% extract of Centella asiatica. In vivo inhibitory effect of the extracts on acetic acid-induced increase in capillary permeability was studied for the assessment of anti-inflammatory activity.

Results

The aqueous and ethanolic extracts of the aerial parts of O. macrosperma demonstrated the highest activity in both wound models and significant anti-inflammatory activity in acetic acid-induced increase in capillary permeability test. Furthermore, ethanolic extract of the aerial parts of O. sessilifolia showed anti-inflammatory effect but was devoid of wound healing activity. The rest of the species did not show remarkable wound healing effect. Ethyl acetate fraction of O. macrosperma ethanolic extract demonstrated significant but reduced wound healing activity, which revealed a possible combined effect. The results of histopathological examination supported the outcome of linear incision and circular excision wound models.

Conclusion

The experimental study revealed that the aerial parts of O. macrosperma display remarkable wound healing and anti-inflammatory activities.     

In vivo anti-inflammatory and wound healing activities of Centaurea iberica Trev. ex Spreng

Aim of the study

Several Centaurea species (Asteraceae) are used in Turkish folk medicine to alleviate pain and inflammatory symptoms in rheumatoid arthritis, high fever, head ache and for wound healing. Particularly, the aerial part of Centaurea iberica Trev. ex Spreng. has been practiced on wounds for healing. In order to evaluate the anti-inflammatory and wound healing activities of the plant, extracts were prepared with variety of solvents: hexane, chloroform, ethyl acetate and aqueous methanol (85%) from the aerial parts of Centaurea iberica.

Materials and methods

The incision by using tensiometer and excision models were used in order to assess the effect of the plant extracts on wound healing in mice and rats. Results were also evaluated histopathologically. In vivo inhibitory effect of the extracts on acetic acid-induced increase in capillary permeability was studied for the assessment of anti-inflammatory activity.

Results

The wound healing effect was comparatively evaluated with a reference ointment Madecassol^®. Noteworthy wound healing activity was observed for the ointment formulation prepared with 1% methanol extract. The results of histopathological evaluation supported the outcome of both incision and excision wound models. Moreover, the methanol extract exerted remarkable wound healing activity and also demonstrated a significant and dose-dependent anti-inflammatory activity.

Conclusion

The experimental study revealed that Centaurea iberica displays remarkable wound healing and anti-inflammatory activity.     

正常人的软组织张力测定

目的 :探讨正常人的软组织张力测定和生物力学特点。方法 :本组 30名健康成年人 ,男 19例 ,女 11例 ,年龄 10～ 5 6岁 ,平均 35岁 ,选取合谷、肩井、三阴交三穴进行垂直于皮肤平面测出 1、2、3、4、6……毫米张力计刻度位移所对应的张力数值。结果 :据所测数值绘出三个部位曲线 ,三处软组织服从大致相同的力学曲线 ,即大体分为皮肤段、皮下组织段、肌内段、深层组织段。结论 :软组织是一种非线性粘弹性材料 ,三处软组织综合刚度合谷穴 <肩井穴 <三阴交穴 ,皮肤刚度小于肌肉的刚度。     

Exploring the wound healing activity of Arnebia densiflora (Nordm.) Ledeb. by in vivo models

Ethnopharmacological relevance

The roots of Arnebia densiflora (Nordm.) Ledeb. (Boraginaceae), which is an endemic plant for Turkey, have been used for healing of wounds in folk medicine. The extract of the roots in olive oil and mostly the root barks was applied onto open wounds for rapid healing.

Aim of the study

To evaluate the wound healing activity of the roots, extracts were prepared with different solvents; hexane, chloroform, ethyl acetate and methanol, respectively from the roots of Arnebia densiflora.

Materials and methods

Incision by using tensiometer and excision models were employed on mice and rats.

Results

Significant wound healing activity was observed with the ointment formulation prepared by using hexane extract at 1% concentration on the mentioned models. The results of histopathological examination supported the outcome of both incision and excision wound models. The wound healing effect was comparatively evaluated with a reference ointment Madecassol^®.

Conclusion

The experimental data demonstrated that Arnebia densiflora displayed remarkable wound healing activity.     

The potential role of female flowers inflorescence of Typha domingensis Pers. in wound management

Aim of the study

Female flowers inflorescence of Typha species including Typha domingensis Pers. are used externally for burns and wound healing in Turkish folk medicine. In order to verify the folkloric assertion, the female and male flowers inflorescences were individually submitted to in vivo wound models.

Material and methods

Ointment formulations prepared directly either from the male or female flowers inflorescences of Typha domingensis in 5% and 10% concentrations were submitted to activity testing. After that, female flowers inflorescence was further submitted to successive extractions with solvents in increasing polarity; i.e., n-hexane, chloroform, methanol and water and the wound healing activity of each extract was investigated. The linear incision and circular excision wound models were used for the evaluation of the healing potential of the test materials in rats and mice. Tissue sections were also evaluated by histopathological techniques.

Results

Remarkable wound healing activity was observed only for the female flowers inflorescence at 5% concentration in ointment base and its methanolic and aqueous extracts. The wound healing effect was found comparable to that of reference ointment Madecassol^®. The results of histopathological evaluation supported the outcome of both linear incision and circular excision wound models.

Conclusion

The experimental study revealed that the female flowers inflorescence of Typha domingensis displayed notable wound healing activity in mice and rats, at the models tested.