Elsevier

Burns

Volume 40, Issue 3, May 2014, Pages 511-519
Burns

Healing efficacy of sea buckthorn (Hippophae rhamnoides L.) seed oil in an ovine burn wound model

https://doi.org/10.1016/j.burns.2013.08.011Get rights and content

Abstract

To investigate the efficacy of sea buckthorn (SBT) seed oil – a rich source of substances known to have anti-atherogenic and cardioprotective activity, and to promote skin and mucosa epithelization – on burn wound healing, five adult sheep were subjected to 3rd degree flame burns. Two burn sites were made on the dorsum of the sheep and the eschar was excised down to the fascia. Split-thickness skin grafts were harvested, meshed, and fitted to the wounds. The autograft was placed on the fascia and SBT seed oil was topically applied to one recipient and one donor site, respectively, with the remaining sites treated with vehicle. The wound blood flow (LASER Doppler), and epithelization (ultrasound) were determined at 6, 14, and 21 days after injury. 14 days after grafting, the percentage of epithelization in the treated sites was greater (95 ± 2.2% vs. 83 ± 2.9%, p < 0.05) than in the untreated sites. Complete epithelization time was shorter in both treated recipient and donor sites (14.20 ± 0.48 vs. 19.60 ± 0.40 days, p < 0.05 and 13.40 ± 1.02 vs. 19.60 ± 0.50 days, p < 0.05, respectively) than in the untreated sites, confirmed by ultrasound. In conclusion, SBT seed oil has significant wound healing activity in full-thickness burns and split-thickness harvested wounds.

Introduction

The skin is the largest organ in the body, and performs numerous vital functions including fluid homeostasis, thermoregulation, immunologic, neurosensory and metabolic functions. The skin also provides primary protection against infection by acting as a physical barrier. When this barrier is damaged, pathogens have a direct route to invade deep tissues. Cutaneous wound healing consists of an orderly progression of events that re-establish the integrity of the damaged tissue. The sequence of events that repairs the damage is categorized into three overlapping phases: inflammation, proliferation and tissue remodeling. The normal healing process can be impeded at any step along its path by a variety of factors [1]. Impaired wound healing may be a consequence of pathologic states associated with diabetes, immune disorders, ischemia, venous stasis and injuries such as burn wounds [2].

Burns are one of the most common and devastating forms of trauma. Impairment of healing in burn injury is characterized by increased free radical-mediated damage, delayed granulation tissue formation, reduced angiogenesis and decreased collagen reorganization leading to chronic wound healing. Burn management entails significant duration of hospital stay, expensive medication, multiple operative procedures and prolonged period of rehabilitation [3]. Topical anti-bacterial agents and disinfectants are beneficial in protecting against infection, but allergic reactions and skin irritations to these agents reduce the rate of skin regeneration and increase the recovery time [4], [5]. However, recombinant growth factors and tissue-engineered wound dressings are highly expensive and beyond the reach of most of the patients in economically developing and underdeveloped countries.

In alternative and complementary systems of medicines such as oriental and aromatherapy, plants are being used to combat several disease and pathological conditions [2], [6], [7], [8]. Herbal products seem to possess moderate efficacy with little or no toxicity and are less expensive as compared to synthetic drugs. Many plants and plant-derived products have been shown to possess potent wound-healing activity [2], [6], [7], [8]. Hippophae rhamnoides L. commonly known as sea buckthorn (SBT), is a branched and thorny nitrogen-fixing deciduous shrub native to Europe and Asia. The plant has been used extensively in oriental traditional systems of medicine for treatment of asthma, skin diseases, gastric ulcers and lung disorders [9].

SBT seed oil is a rich source of unsaturated fatty acids, and recently it is becoming more attractive and commonly used in the area of skin care because of its abundant omega-7 unsaturated fatty acid content. Omega-7 is known to promote epithelization of skin and mucosal tissue [10], [11]. The aim of the present study was to investigate the efficacy of SBT seed oil on burn wound healing to explore underlying mechanisms of its salutary effects.

Section snippets

Animal care

The Institutional Animal Care and Use Committee at the University of Texas Medical Branch approved this study. The guidelines of the National Institutes of Health for the care and use of experimental animals were carefully followed. Animals were individually housed in metabolic cages and, although the injury was accomplished under deep anesthesia, sheep were studied in awake state.

Surgical preparation and experimental protocol

Five female Merino sheep (29 ± 1 kg) were used in this study. For the operative procedures, sheep were anesthetized,

Autograft closure

Six days after the grafting, no remarkable differences were observed between treated and untreated sites. However 14 days after the grafting, the mean percentage of epithelized wound was significantly greater in treated sites than in untreated sites (95 ± 2.23 vs. 83 ± 2.91%, p < 0.05) (Fig. 2A and B). The complete epithelization time of the treated grafted site was significantly shorter than that of the untreated grafted site after the grafting (12.20 ± 0.48 vs. 19.60 ± 0.40 days, p < 0.05) (Fig. 3).

Donor site healing

There

Discussion

Although the clinical care of burn patients is significantly advanced and the mortality of burn patients without smoke inhalation injury has been dramatically reduced in the past decade, the clinicians still face problems such as wound infection, rejection of skin graft, delayed wound healing and hypertrophic scarring. One of the most challenging problems is the shortage of cover material.

The approach to skin coverage in the massively burned patient depends on the type and extent of the injury.

Conflict of interest

The authors declare that there are no conflicts of interest.

Acknowledgements

The authors thank the staff of the Investigational Intensive Care Unit at the University of Texas Medical Branch for their valuable assistance in conducting these studies. This study was supported by grants from the Shriner's of North America, #85500, #85410.

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