Efficacy and safety of Resina Draconis for wound repair in the treatment of diabetic foot ulcer: A systematic review and meta-analysis of randomized controlled trials

Background and purposeResina Draconis (RD) is widely used to treat topical skin ulcers. However, its effect on diabetic foot ulcer (DFU) remains unknown. The present meta-analysis aims to evaluate the efficacy and safety of RD for wound healing in DFU treatment.MethodsLiterature searches were conducted with databases including PubMed, Embase, Cochrane Library, the China National Knowledge Infrastructure, the Wanfang Database, the Database for Chinese Technical Periodicals, and the China Biology Medicine Disc. Relevant studies were selected based on specified inclusion and exclusion criteria. Software RevMan 5.4 was used for study selection, quality assessment, and data analysis, while the Cochrane Risk of Bias (RoB) 2.0 tool was used to assess RoB.ResultsNine eligible randomized controlled trials (RCTs), involving 679 patients, were included in this review. The results showed that the healing time of the RD group was shorter than that of the control group (P < 0.00001), while the RD group also presented a higher healing rate (P < 0.0001), a higher rate of ulcer area reduction (P = 0.0005), and a higher rate in the patients with a reduced Wagner grade (P = 0.002). Simultaneously, a lower frequency of dressing changes (P < 0.00001) and a shorter length of hospital stays (P < 0.00001) are the characteristics of the RD group as well.ConclusionThe treatment with RD is a safe and effective solution for DFU, and its combination with conventional treatment can improve the healing rate of DFU, reduce healing time, and inhibit further development. However, owing to the limited quality and quantity of included studies, further high-quality research is necessary to support these conclusions.     

Topical Application of Honey in Treatment of Abdominal Wound Disruption

The usefulness of honey application as an alternative method of managing abdominal wound disruption was assessed. Fifteen patients whose wound disrupted after Caesarean section were treated with honey application and wound approximation by micropore tape instead of the traditional method of wound dressing with subsequent resuturing. We achieved excellent results in all the cases with complete healing within 2 weeks. Honey application is inexpensive, effective and avoids the need to resuture which also requires general anaesthesia.     

Microencapsulated rhEGF to facilitate epithelial healing and prevent scar formation of cesarean wound: A randomized controlled trial

ObjectiveCesarean section (CS) is a major surgical intervention that affects women at childbearing age. Scarring from CS potentially causes discomfort and psychological distress. Emerging evidence indicates that epidermal growth factor (EGF) plays crucial roles in wound healing with the potential of minimizing scar formation. This study aims to investigate the effect of microencapsulated recombinant human EGF (Me-EGF) in scar prevention. Silicone gel was incorporated as part of the routine scar treatment.Materials and methodsHealthy women scheduled for cesarean delivery were enrolled and randomized to three groups: (1) no scar treatment, (2) silicone gel only, or (3) silicone gel plus Me-EGF. Vancouver Scar Scale (VSS: vascularity, pigmentation, elasticity, and height) was used for scar assessment at the 6th month and 9th month after CS.ResultsA total of 60 women were enrolled, but one patient withdrew due to noncompliance with the follow-up visit requirement. Me-EGF-containing treatment group consistently scored the lowest on every parameter in the VSS scale, followed by silicone gel group, and the group with no scar treatment. Kruskal–Wallis tests indicated significant differences (p < 0.05) between Me-EGF-containing treatment group and the other two groups in vascularity, pigmentation, elasticity, and the VSS total score, at either 6th month, 9th month, or both time points. The only parameter not showing any significant between-group difference was scar height, but the pattern still remained the same, in which Me-EGF group scored better in both month 6 and 9.ConclusionSurgical incisions in lower abdomen posed challenge in scar management. Our findings suggest that Me-EGF is a potential therapeutic option for better wound healing and scar prevention.     

Cesarean wound scar characteristics for the prediction of pelvic adhesions: a meta-analysis of observational studies

Objective: The pathophysiologic processes that result in wound healing are the same regardless of the tissue involved. The purpose of the present meta-analysis is to evaluate whether cesarean scar characteristics may predict the presence of pelvic adhesions.

Materials and methods: We conducted a systematic review searching the Medline (1966–2016), Scopus (2004–2016), ClinicalTrials.gov (2008–2016), Cochrane Central Register of Controlled Trials CENTRAL (1999–2016) and Google Scholar (2004–2016) databases together with reference lists from included studies. All prospective and retrospective observational cohort studies were included. Statistical meta-analysis was performed using the RevMan 5.1 software.

Results: Current evidence suggests that depressed scars are positively associated with intra-abdominal adhesions (ΟR 2.79, 95%CI 1.74–4.46). Elevated scars might also correlate with the presence of adhesions, however, this association did not reach statistical significance (OR 1.61, 95%CI 0.91–2.85, p?=?0.10). The same was reported in the case of scar pigmentation (REM, OR 1.68, 95%CI 0.86–3.26, p?=?0.13). Flat scars were predictive of the absence of adhesions (899 patients, REM, OR 0.33, 95%CI 0.23-0.54, p?Conclusion: According to our meta-analysis, abdominal wound characteristics following cesarean section can predict the presence of adhesions. However, given the small number of published studies, further research is needed to corroborate our findings.     

贻贝粘蛋白敷料在宫颈LEEP术后创面修复及阴道微生态恢复中的应用

目的： 评价贻贝粘蛋白（mussel adhesive proteins,MAP）敷料在宫颈环形电切术（loop electrosurgical excision procedure,LEEP）术后创面修复和阴道微生态恢复中的临床应用价值。方法： 选取2020年11月—2021年4月因病理诊断宫颈鳞状上皮内病变行LEEP的患者,术后随机分为MAP组（30例）和不含MAP的安慰剂敷料对照组（30例）,对比2组患者术后第3周创面愈合情况和术后第5周阴道微生态变化。结果： LEEP术后第3周,MAP组的创面愈合比例明显高于对照组（53.33% vs. 13.33%,P=0.001）;LEEP术后第5周,MAP组的阴道微生态较对照组明显好转（66.67% vs. 3.33%,P=0.000）。结论： MAP敷料能够有效缩短宫颈LEEP术后创面愈合时间,改善阴道微生态。     

Honey in the management of side effects of radiotherapy- or radio/chemotherapy-induced oral mucositis. A systematic review

Backgroundand purpose: In spite of several trials, systematic reviews and meta-analyses, honey is not considered as a viable candidate for the prophylaxis and treatment of radiotherapy-induced oral mucositis in the practice guidelines for supportive care. The purpose of this study was to analyse the value of honey in this treatment situation based on randomized trials acknowledging the fact that manuka honey which is used in some trials distinguishes itself from other honey due to the presence of methylglyoxal.MethodsOn the basis of a literature search, we identified and analysed 17 randomized trials on the topic. Participants in these trials received radiotherapy or a combination of radiotherapy and chemotherapy for head and neck cancer.ResultsStudies using manuka honey found little rationale for the medicinal use of honey (n = 4) in this field, whereas trials using conventional honey presented data on its usefulness (n = 13). Thus, the type of honey may explain the divergent results of trials in this area.ConclusionConventional honey is likely to be effective in the prophylaxis and treatment of radiation- and chemoradiation-induced oral mucositis.     

Effectiveness of osteopathic interventions in patients with non-specific neck pain: A systematic review and meta-analysis

ObjectiveThe aim of this systematic review and meta-analysis is to evaluate whether osteopathic manipulative interventions can reduce pain levels and enhance the functional status in patients with non-specific neck pain (NS-NP).MethodsA systematic review and meta-analysis was conducted following the 2020 PRISMA statement. Randomized controlled trials (RCTs) were searched in five databases, assessed through a standardized form, and evaluated using the “13 items Cochrane risk of bias (RoB) tool”. Effect sizes (ES) were calculated post-treatment, and the quality of evidence was assessed through GRADE criteria.ResultsFive articles were included in the review, and none of these was completely judged at low RoB. Four of these were included in the meta-analysis. Osteopathic interventions compared to no intervention/sham treatment showed statistically significant results for pain levels (ES = −1.57 [-2.50, −0.65]; P = 0.0008) and functional status (ES = −1.71 [-3.12, −0.31]; P = 0.02). The quality of evidence was “very low” for all the assessed outcomes. Other results were presented in a qualitative synthesis.ConclusionsOsteopathic interventions could be effective for pain levels and functional status improvements in adults with NS-NP. However, these findings are affected by a very low quality of evidence. Therefore, further high-quality RCTs are necessary to improve the quality of evidence and generalize the results.     

Optimal skin antiseptic agents for prevention of surgical site infection in cesarean section: a meta-analysis with trial sequential analysis

Purpose: The best choice of antiseptic agent for skin preparation at cesarean section remains controversial. We performed this meta-analysis to assess whether chlorhexidine (CH)-based skin antisepsis was more effective than povidone iodine (PI)-based antisepsis for the prevention of surgical site infection (SSI) after cesarean section.

Methods: PubMed, EMBASE, and the Cochrane Library were systematically searched to identify English publications that compared chlorhexidine gluconate (CH) as a skin preparation agent with PI in cesarean section. The primary outcome was SSI rate. Review Manager 5.3 was used to analyze the collected data and trial sequential analysis (TSA) Software 0.9 (Cochrane Collaboration, Oxford, UK) beta was applied to estimate whether the overall pooled outcome was conclusive.

Results: Six articles involving 4385 participants were included in this study. The outcomes showed that CH-based skin antisepsis, compared with PI-based antisepsis, was not associated with a decreased overall rate of SSI (risk ratio [RR], 0.74; 95% confidence interval [CI], 0.54–1.02; p?=?.07). TSA indicated that the current available evidence was inconclusive. There were no differences in adverse skin reactions in the two groups.

Conclusions: This study provides evidence that CH-based antisepsis for skin preparation does not show an additional advantage in reducing risk of SSI after cesarean section. However, additional high-quality, randomized clinical trials are needed to confirm these findings.     

Astragalus polysaccharides and astragaloside IV ameliorates cyclophosphamide-induced mouse model of overactive bladder

ObjectivePrevious studies have shown that Astragalus polysaccharides (APS) and Astragaloside IV (AS-IV) protect against inflammation-related cell damage and exhibit immune enhancement. Since urothelial injury may result in an overactive bladder (OAB), the aim of this study was to investigate the efficacy of APS and AS-IV on urothelial injury in an experimental animal model.Materials and methodsThe effects of APS and AS-IV on the proliferation and migration of primary human urothelial cells (HUCs) or primary human fibroblast cells (HFCs) were assessed using an in vitro wounding model and colorimetric thiazolyl blue assays. Sixty virgin female mice were randomized into five groups: group 1–saline-injected plus treatment with H₂O, group 2–cyclophosphamide (CYP) plus treatment with H₂O, group 3–CYP plus treatment with solifenacin succinate (SS; 10 mg/kg), group 4–CYP plus treatment with AS-IV (100 mg/kg), and group 5–CYP plus treatment with APS (100 mg/kg). Cystometry assessment was conducted and cell junction-associated protein zonula occludens-2 (ZO-2) expression was measured. Voiding interval values (time between voids) were assessed in mice under anesthesia. Lastly, immunohistochemistry analysis was used to confirm the location and level, respectively, of ZO-2 expression.ResultsAPS and AS-IV did not influence the cell viability but increased migration in HFCs compared with the controls. The OAB mice showed significantly lower voiding interval values. Voiding interval values were significantly higher in the CYP plus treatment with APS (100 mg/kg) and AS-IV (100 mg/kg) groups than in the CYP-induced OAB group. Additionally, the expression of ZO-2, a tight junction protein, was increased in the CYP plus treatment APS (100 mg/kg) and AS-IV (100 mg/kg) groups compared with the CYP-induced OAB group.ConclusionThese findings suggest that APS and AS-IV modulate urothelial wound healing, which ameliorates urinary frequency of mice treated with CYP. APS or AS-IV may have the potential benefit of acting as urothelial wound healing modulators.     

A prospective trial comparing Biobrane, Duoderm and xeroform for skin graft donor sites

Many new dressings have been introduced for use on split-thickness skin graft donor sites in an effort to reduce pain at the donor site and decrease healing time, while maintaining a low infection rate and cost. To assess these factors in two such dressings, Biobrane (temporary wound dressing) (Winthrop) and Duoderm (hydrocolloid dressing) (Convatec), we compared them with a conventional fine mesh gauze dressing, xeroform, in a prospective, randomized study of 30 donor sites in the same number of patients. Wounds were considered healed when they were 100 per cent re-epithelialized and required no further dressings. Patient self-assessment of pain was quantified on a scale of zero to ten, with ten being the most severe pain. Donor sites dressed with xeroform had a healing time of 10.5 days, which was significantly better (p less than 0.05) than Duoderm (15.3 days) or Biobrane (19.0 days), although the protocol for Duoderm use (wound visualization at seven day intervals) extended the apparent healing times in this group. Duoderm was the most comfortable dressing (0.53 grade) when compared with Biobrane (1.44) and xeroform (2.41, p less than 0.05). No infections occurred in donor sites dressed with xeroform, but two developed in patients using Biobrane. One patient with a Duoderm dressing had a donor site infection during a drug-related neutropenic reaction. Xeroform was the least expensive dressing to use ($1.16 per patient), followed by Duoderm ($54.88 per patient) and Biobrane ($102.57 per patient). The results of our study confirm the usefulness of xeroform as a donor site dressing as it promotes relatively rapid healing, is easy to use and is inexpensive. We found Duoderm to be ideal for smaller donor sites when pain could be significantly reduced with minimal increase in cost. Biobrane is too costly and the infection rate too high for it to be used routinely as a skin graft donor site dressing.     

Extensive Adipose Tissue Necrosis Following Pfannenstiel Incision for Endometrial Cancer

BackgroundHematomas are potential postoperative complications that may arise from Pfannenstiel incisions. They usually either resolve spontaneously or are drained depending on their extent. Major risk factors such as obesity and diabetes may lead to superimposed complications and further worsen the outcomeCaseA 73-year-old woman presented with a large subcutaneous hematoma 10 days after total abdominal hysterectomy done through a Pfannenstiel incision for endometrial cancer. The hematoma progressed and led to extensive subcutaneous fat necrosis. Extensive debridement was required, and negative pressure wound therapy with gauze was used to allow second intention closure. Satisfactory healing was achieved after 82 days of treatment without skin grafting.ConclusionThis case highlights the usefulness of gauze-based negative pressure wound therapy, as well as the need for a multidisciplinary approach in taking care of such complex wound complication     

Unique infective complication after routine vasectomy: a case report

IntroductionWe present a case of a 51‐year‐old gentleman who, after undergoing routine vasectomy, presented with an infected wound 7 days after the procedure—one day after receiving oral sex from his wife.AimWe hope to present a unique case of an infected wound after oral sex. Group A Streptococcus (GAS) was cultured from the patient's wound and the asymptomatic wife's pharyngeal mucosa.Main Outcome MeasuresTo educate and expose a rare but potentially devastating postvasectomy complication that, without prompt and aggressive treatment, can lead to significant morbidity.MethodsThe patient was promptly treated and after hydration, broad spectrum antibiotics, and supportive care, patient showed excellent recovery. The wife was also treated with oral antibiotics.ResultsInfective complicated are relatively uncommon after routine vasectomy. When present, the vast majority of the infections are treated with a simple course of oral antibiotics. There is strong evidence that establishes oral contact as a vector for transmission of virulent pathogens. Some have linked orogenital transmission of GAS since the 1970s.ConclusionTo our knowledge, this is the first reported case of oropharyngeal transmission of GAS that led to rapidly progressive infection of the scrotum following vasectomy. Care should be taken to minimize exposure during postoperative healing. Ramaswamy K and Kaminetsky J. Unique infective complication after routine vasectomy: A case report. J Sex Med 2011;8:2655–2658.     

The role of intra-peritoneal honey administration in preventing post-operative peritoneal adhesions

OBJECTIVE(S): The accelerative effect of honey in the wound healing process is known. This effect is related to its specific physical properties of hygroscopicity, hypertonicity, lower pH and complex chemical composition. Because peritoneal healing is a kind of wound healing process we hypothesised that post-operative peritoneal adhesions (PPA) may be reduced with intra-peritoneal honey administration. STUDY DESIGN: The study was conducted with 40, 6-month-old, out-bred female Wistar albino rats with a mean weight of 197 +/- 12 g. The rats were divided into two equal groups. An adhesion model was constituted in the cecum and terminal ileum of all rats in each groups. Later the adhesion areas were washed with 0.9% NaCl solution and 5 ml of the same solution was left in the peritoneal cavity in the control group. The same area in the rats in the other group was covered with honey and 5 ml of honey was left in the peritoneal cavity of each animals. Ten days later the rats were sacrificed and the adhesions were graded according to their degree of severity. Statistical analysis was performed with the non-parametric Mann-Whitney U-test. RESULTS: In the control group, there were no rats with grade-0 or grade-1 adhesions but in the honey administered group there were six rats (30%) with grade-0 and 12 rats (60%) with grade-1 adhesions. In the control group, there were six rats (30%) with grade-2 and 14 rats (70%) with grade-3 adhesions. In the honey administered group while two rats (10%) with grade-2 adhesions were present, no rat with grade-3 adhesions was seen. In the comparison, the difference between the groups was found to be highly significant (P < 0.001). CONCLUSION(S): The wound healing accelerative effect and the mechanical barrier formed by the honey, since, it has a high density and, thus, absorbed slowly from peritoneal cavity, may be the reasons for its inhibitory effect on the PPA. This study indicates that though the mechanism is not clear intra-peritoneal honey administration reduces PPA.     

The associations of CYP19A1 rs700518 polymorphism with bone mineral density and risk of osteoporosis: a meta-analysis

Abstract

Osteoporosis is now a worldwide public health problem that seriously endangers human health, but its causes have not yet been fully clarified. Recently, increasing evidence suggested that polymorphisms in CYP19A1 gene were associated with osteoporosis risk and bone mineral density (BMD), but results remained conflicting. We herein performed a meta-analysis based on evidence currently available from the literature to make a more precise estimation of these relationships. The PubMed, Embase, Cochrane library, CNKI (China National Knowledge Infrastructure), and Wan Fang databases were searched for eligible studies. Odds ratio (OR), mean difference (MD), and 95% confidence interval (CI) were applied to assess the strength of these relationships. A total of 8 studies involving 2632 subjects were included in our meta-analysis. We observed that the AG genotype of CYP19A1 rs700518 was significantly associated with lower BMD values of lumbar spine and femoral neck (AG vs. GG: p?=?.001 and.01, respectively). However, this polymorphism had no obvious impacts on osteoporosis risk according to current available data. In conclusion, the present meta-analysis showed that CYP19A1 rs700518 polymorphism may be a potential candidate biomarker for osteoporosis screening, early diagnosis, and treatment, which will help improve individualized therapy of osteoporosis patients in clinics.     

Comparison of magnetic resonance-guided high-intensity focused ultrasound with uterine artery embolization for the treatment of uterine myoma: A systematic literature review and meta-analysis

ObjectiveThis study aimed to compare the outcomes of magnetic resonance-guided (MR-g) high-intensity focused ultrasound (HIFU) with uterine artery embolization (UAE) for the treatment of uterine myoma.Materials and methodsA systematic literature review and meta-analysis was conducted using database searches of Medline, Cochrane, EMBASE, and Google Scholar. Articles were searched through March 25, 2020. Outcomes of interest were Symptom Severity Score (SSS), Health-related Quality of Life (HRQoL), re-intervention rate, and rate of adverse reactions in patients with uterine myoma.ResultsFour studies were included with a total of 207 patients with uterine myomas who received MR-g HIFU and 201 who received UAE. UAE was associated with a greater reduction in SSS, improved HRQoL, and a significantly lower re-intervention rate compared with MR-g HIFU in 3 of 4 included studies. No significant differences were found in the incidence and severity of adverse events between treatment arms in one study, but differences were observed in the percentage of adverse reactions in another.ConclusionPublished evidence suggests that the efficacy of MR-g HIFU may not be superior to that of UAE in the treatment of uterine myoma.     

Systematic Review and Meta-Analysis of the Effect of Nutrients on Blood Lead Levels in Pregnancy

ObjectiveTo synthesize experimental and nonexperimental research on the relationship between nutrients and blood lead levels in pregnant women. We also performed a meta-analysis on a subgroup of studies on calcium and blood lead levels.Data SourcesPubMed, Embase, and CINAHL databases were searched in July 2019.Study SelectionWe included articles published in English in any year that reported the results of experimental or observational studies on the effect of nutrients on blood lead levels in pregnancy.Data ExtractionThree nurse reviewers extracted data and appraised the studies using tools from the Joanna Briggs Institute.Data Synthesis and Meta-AnalysisWe included 28 studies from 16 countries. Study authors examined 14 distinct nutrients, with calcium being the most frequent. The metaregression included nine analyses of the effect of calcium on blood lead levels and showed a small but significant inverse relationship. The quality of evidence for the effect of calcium on lead levels was high. Eleven analyses were related to the effect of iron on blood lead levels. The quality of evidence was high, and we found mostly negative associations between iron intake and blood lead levels. The quality of evidence for the remaining nutrients was moderate, with few significant findings.ConclusionTargeted nutritional interventions may be beneficial for pregnant women with current lead exposure or a history of elevated lead levels, particularly those with calcium- or iron-deficient diets. More rigorously designed studies are needed in this area.     

Is energy healing an effective non-pharmacological therapy for improving symptom management of chronic illnesses? A systematic review

BackgroundEmerging evidence suggests that some people living with non-communicable diseases (NCDs) have integrated energy healing into their self-management strategy, however little is known about its efficacy.PurposeTo identify energy healing interventions that impacted positively on the symptom management outcomes for patients living in the community with various NCDs.MethodsA systematic review of energy healing interventions for the management of non-communicable disease related symptoms, conducted between 01 January 2000 and 21 April 2015, published in an English peer-reviewed journal. This review conforms to the PRISMA statement.ResultsTwenty seven studies were identified that evaluated various energy healing interventions involving 3159 participants. Thirteen of the energy healing trials generated statistically significant outcomes.ConclusionsEnergy healing has demonstrated some improvement in illness symptoms, however high level evidence consistently demonstrating efficacy is lacking. Further more robust trials are required to better understand which elements of energy healing interventions are associated with positive outcomes.     

Advances in Suture Material for Obstetric and Gynecologic Surgery

Despite millennia of experience with wound closure biomaterials, no study or surgeon has yet identified the perfect suture for all situations. Tissue characteristics, tensile strength, reactivity, absorption rates, and handling properties should be taken into account when selecting a wound closure suture. This review discusses the wound healing process and the biomechanical properties of currently available suture materials to better understand how to choose suture material in obstetrics and gynecology.Key words: Suture, material; Suture, tensile strength; Suture, absorption rate; Wound healingThe relationship between wound closure biomaterials and surgery dates back as far as 4000 years, when linen was used as a suture material. The list of materials used to close wounds has included wires of gold, silver, iron, and steel; dried gut; silk; animal hair; tree bark and other plant fibers; and, more recently, a wide selection of synthetic compositions. Despite millennia of experience with wound closure biomaterials, no study or surgeon has yet identified the perfect suture for all situations.A perfect suture would have the following properties:

• Adequate strength for the time and forces needed for the wounded tissue to heal
• Minimal tissue reactivity
• Comfortable handling characteristics
• Unfavorable for bacterial growth and easily sterilized
• Nonelectrolytic, noncapillary, nonallergenic, and noncarcinogenic

This review discusses the wound healing process and the biomechanical properties of currently available suture materials to better understand how to choose suture material in obstetrics and gynecology.     

Effect of grape seed extract ointment on cesarean section wound healing: A double-blind,randomized, controlled clinical trial

Backgroundand purpose: Complications of the delayed recovery of cesarean section (CS) wound can include stress, discomfort, and dissatisfaction of the mother in the postpartum period. This study tried to determine the effect of grape seed extract ointment on CS wound healing.Materials and methodsThis is a double-blind, randomized, controlled clinical trial incorporating 129 women eligible for CS in eastern Iran. Participants were selected through convenience sampling method and were subsequently randomly assigned into three groups: 2.5% grape seed extract ointment, 5% grape seed extract ointment, and petrolatum. CS wound healing indices were assessed before the intervention, and 6 and 14 days after the intervention using the REEDA scale (redness, edema, ecchymosis, discharge, and approximation).ResultsThe mean scores on days 6 and 14 after intervention were respectively 2.02 ± 0.52 and 0.98 ± 0.61 in the 5% ointment group, 2.83 ± 0.54 and 1.58 ± 0.67 in the 2.5% ointment group, and 2.91 ± 0.51 and 1.55 ± 0.74 in the petrolatum group. While the mean score in the 5% ointment group was significantly different from those of 2.5% ointment and petrolatum groups (P < 0.001), the mean score in the 2.5% ointment group was not significantly different from that of the petrolatum group on days 6 and 14 after intervention (P = 0.38 and P = 0.79, respectively).ConclusionThe current results suggest that 5% grape seed extract may have beneficial therapeutic effects in promoting CS wound healing.