The Effects of Topically Applied Nitrofurazone and Rifamycin on Wound Healing

Mutlu Saydam, MD; Sarper Yilmaz, MD; Ergin Seven, MD; Ali Riza Erçöçen, MD; Serkan Saydam, PhD; Hafize Sezer, PhD

Disclosures

Wounds. 2006;18(3):71-76. 

In This Article

Materials and Methods

Fifty Wistar rats weighing 250-350 g were used in the study. The animals were kept in standard metal cages and provided with food and water ad libitum. Anesthesia was administered intramuscularly with xylazine hydrochloride (Rompun 2%, Bayer Kimya San. Ltd. Sti., Istanbul, Turkey) and with 5 mL/kg ketamine hydrochloride (Ketalar, EWL Eczacibasi Warner Lambert Ilaç Sanayi ve Ticaret A.S., Istanbul, Turkey). After cutting the hairs, 2 circular full-thickness defects with a diameter of 1.5 cm were created on the dorsal left superior and right inferior regions of the rats (Figure 1) In all groups, daily wound care was performed by cleansing the wound with 0.9% NaCl solution. The surface area of each circular defect was 176.6 mm[2]. The dimension of the gauze used in wound care was 30 cm x 34 cm. For each rat, 1/250 of the gauze was used making the surface of the gauze approximately 4 cm[2]. The experimental and control groups contained 10 rats (n = 10). In this study, the authors utilized a clinical method that has been in use for more than 10 years and is a traditional technique used in Turkey. For this reason, a secondary occlusive dressing was not used to obtain a moist environment.

Figure 1.

The view of wounds after a full-thickness excision

Experimental Groups

Nitrofurazone Group. To mimic clinical use, a 56-g tube of nitrofurazone (Furacin, 0.2%, Eczacibasi Ilaç Sanayi ve Ticaret A.S., Istanbul, Turkey) was simply absorbed by 2 gauzes in the nitrofurazone group. The average nitrofurazone dosage was approximately 0.1 g for each wound.

Rifamycin Group. The standard gauze was soaked with 1 ampule of rifamycin (Rif 250 mg injectable form, Koçak Ilaç A.S., Istanbul, Turkey). The average dosage of rifamycin was approximately 1 mg for each wound.

Nitrofurazon-Rifamycin Combination Group. The above methods were combined in this group.

Control Groups

Neomycin-Bacitracin Group. Animals in the neomycin-bacitracin group received 1/256 of the standard gauze that had absorbed a combination of neomycin and bacitracin (Thiocilline pom 10 g, Abdi Ibrahim Ilaç Sanayi, Istanbul, Turkey). The average dosage was 0.08 g per wound. The neomycin-bacitracin group was selected as a control group because this formula is widely accepted for wound care in Europe and the United States.

No Treatment Group. Wounds in this group were merely cleansed daily with isotonic NaCl.

All wounds were cleansed with NaCl jet lavage prior to treatment with agents.

Evaluation of the Wounds

The course of wound healing was assessed by drawing the circumference of the wound on acetate paper with permanent 0.3-mm markers (Figure 2). Measurements were performed on Days 3, 6, 9, 12, and 30. The wounds were evaluated every 3 days with photography and millimetric measurement. However, during daily treatments, when complete healing was observed, the wound was recorded as completely healed. Statistical analysis was performed only on data from the "exact" day of healing. Evaluations were made for the purpose of obtaining information about the course of healing.

Figure 2.

Measurement of wound surface using a millimetric scale on acetate paper during the healing period.

Calculation of the wound surfaces was performed with a special software (Surfer 7.0, Golden Software, Golden, Colo) developed for map drawing in mining and geology. The drawings obtained from the wounds were transferred to the computer.

Statistical Evaluation

The data derived from the study was transferred to Statistical Package for the Social Sciences (SPSS) software (SPSS Inc., Chicago, Ill). In order to eliminate healing differences between the upper and lower wounds, wounds were also analyzed separately. The Kruskal-Wallis test was performed to compare groups. The significant values obtained from this test were assessed with the Mann-Whitney U test.

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