The Effects of Nitrofurazone on Wound Healing in Thoracoabdominal Full-Thickness Skin Defects

Sami Karapolat, MD; Banu Karapolat, MD; Alaaddin Buran, MD; Burcu Kemal Okatan, MD; AtilaTurkyilmaz, MD; Turan Set, MD; CelalTekinbas, MD

Disclosures

Wounds. 2020;32(5):134-141. 

In This Article

Abstract and Introduction

Abstract

Introduction: The use of topical antibiotics on wound healing has been a matter of debate for many years because of the effectiveness.

Objective: The aim of this study is to investigate the potential effects of topical nitrofurazone, an antibacterial agent, on the healing of full-thickness skin defects created in a laboratory setting.

Materials and Methods: A total of 42 adult male Sprague Dawley rats were divided into 2 groups: group A (control group; n = 21) and group B (nitrofurazone group; n = 21). Circular full-thickness skin defects about 1 cm x 1 cm in size were formed in the left thoracoabdominal regions of all rats. Local physiological saline was applied to the wound once daily in the control group, and a thin layer of nitrofurazone cream was applied to the wound topically once daily in the nitrofurazone group. The defect sizes of all rats were photographed at baseline and days 3, 7, and 10 of the experiment, and wound size reduction was measured macroscopically on the computer to calculate the healing rates. A total of 7 rats from each group were euthanized on days 3, 7, and 10, and their defected regions were resected. The removed specimens were evaluated histopathologically and scored for inflammatory cells, collagen accumulation, granulation tissue formation, reepithelization, and features of the skin defect (eg, layers of the skin affected, size, whether it involves any abscess-necrosis). Statistical significance was set at P < .05.

Results: The healing rate had higher values in group B at days 7 and 10 of the experiment (P < .001). A comparison of the group scores showed that there were statistically significant differences in favor of group B. No statistically significant difference was found between the 2 groups with respect to granulation tissue formation.

Conclusions: Topically applied nitrofurazone produced positive effects accelerating the wound healing process.

Introduction

Wound healing is a complex, active, and dynamic process that aims to reestablish tissue integrity and reverse loss of function. It is not yet fully understood how wound healing is regulated at the molecular level.[1,2] Ideal wound healing should occur within an acceptable timeframe and be cosmetically acceptable to the patient. Various factors affecting certain stages of the wound healing process lead to positive or negative developments in the morphological and functional integrity of the tissue.[1–3] These factors include age, sex, race, ethnicity, nutrition, circulation, tissue oxygenation, infections, and some hormones such as glucocorticoids, insulin, and thyroid hormones.[1,2] If a wound infection occurs in any region of the body, healing can be delayed.[1] In acute and chronic wounds (eg, burns, pressure injuries, granulated wounds), with high positive culture rates prior to treatment, topically applied antibiotics aim to reduce the bacterial load, which eliminates the unfavorable effect of bacterial colonization on wound healing, and reduce the need for systemic antibiotic use.[4,5] Moreover, topical antibiotics are easily applied, typically have limited systemic absorption and toxicity, produce low systemic concentration but high wound concentration, and prevent the development of resistance to antibiotics.[4] However, the effect of these drugs on the wound healing rate and epithelization should be investigated.[5]

In the literature, there is documentation of the use of various topical antibiotics, such as bacitracin, polymyxin B, neomycin, silver sulfadiazine, nystatin, gentamicin, acetic acid, silver nitrate, and nitrofurazone.[3,6,7] Several animal studies have focused on wound healing with topically applied nitrofurazone.[6,8,9] In an experimental study on adult Japanese quails (Coturnix japonica), nitrofurazone was found to accelerate wound healing macroscopically and had no negative effect on recovery.[6] Geronemus et al[8] studied partial-thickness wounds in white domestic pigs and assessed epithelization; the authors reported that nitrofurazone significantly delayed wound healing by 24%.[8] Saydam et al[9] found nitrofurazone, which was topically applied on full-thickness tissue wounds formed in the back regions of rats, significantly delayed wound healing when used alone but had no negative effect on wound healing when combined with rifampicin.[9]

The present experimental study investigated the effects of topical application of nitrofurazone on acute surgical wound healing in full-thickness skin defects formed at the thoracoabdominal regions of rats.

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