Father wounds

NPWT combined with porcine ADM dressing can effectively remove wound bacteria, reduce wound exudation, and promote wound healing in repairing deep partial-thickness burn wounds and full-thickness burn wounds. Its clinical effect is better than NPWT or porcine ADM dressing alone, and this method may be suitable for patients with non-surgical treatment.

To explore the clinical efficacy of tangential excision of deep partial thickness burn wound without tourniquet during an early stage. A total of 32 patients with a large area of deep partial thickness burn wounds were operated within 24 h post-burn. The lamellar tangential excision was on the basis of stable index of resuscitation from shock without tourniquet. And the depth of tangential excision was achieved to the extent of uniform punctate hemorrhage on burn wounds. Xenogenic acellular dermal matrix was applied after hemostasis with diluted adrenaline. The intraoperative blood loss volumes, operative durations, pre- & post-operative temperatures, length of wound healing, the quality of wound healing and the contracture extent of scars of 1%TBSA (total body surface area) wound were recorded and compared with the published data. Thirty-one patients completed the whole clinical observation. The intraoperative blood loss volume of 1% TBSA wound was (8.8 ± 0.9) ml, the operative duration of 1%TBSA wound was (0.52 ± 0.06) min, the temperature at Day 5 was (37.7 ± 0.7)°C and it was significantly lower than that at 24 h [(38.6 ± 0.6)°C] (t = 0.42, P < 0.05), the length of wound healing was (25.2 ± 2.2) d. There were significantly statistical differences in terms of the operative durations, the temperature at Day 5 and the length of wound healing with the corresponding literature reports with intra-operative uses of tourniquets (all P < 0.05). The percentage of the quality of wound healing was 100% at Month 3. The development of scar proliferation were observed in varying degrees. Mild contracture of wounds appeared after 6 month post-burn. But all joints could move with ease and had no obvious dysfunction. Lamellate tangential excision of deep partial thickness burn wound during an early stage without tourniquet have advantages of smaller volumes of intraoperative blood loss, shorter operation duration and simpler procedures. Also the depth of tangential excision is easier to control so as to enhance the quality of wound healing.

Background Negative pressure wound therapy (NPWT) includes closed vacuum drainage (VSD) technology and vacuum assisted closure (VAC) technology, which have been used as the new treatments to promote acute and chronic wound healing for nearly 20 years. Currently, the Medline database has collectively referred to these techniques as the negative pressure wound therapy (NPWT) . Among them, VAC is a medical foam material with pore spaces (commonly using hydrophobic polyurethane foam dressing) to cover the wound after debridement, and is sealed with a transparent film to form a confined space. Then it is connected with a dedicated negative pressure pump for continuous or discontinuous negative pressure suction, so as to fully drain wound exudate and infectious substances, reduce edema, increase local blood flow, reduce the number of bacteria on the wound, and accelerate the growth rate of granulation tissue, thereby effectively promoting of secondary or tertiary (delayed) wound healing. In recent years, VAC has been widely used in trauma orthopedics, mainly for acute and chronic wounds, soft tissue infections, ulcers (such as diabetic ulcers or pressure sores) , and wounds before and after flap transplantation. Due to the complexity of the VAC tubing connection, the lack of preventive measures against unplanned extubation during clinical care can result in wound exposure, increase the incidence of complications, and lead to adverse care events. Different methods of tubing fixation have various effects in preventing unplanned extubation. Therefore, the innovative fixation of the VAC tubing fixation method ensures safe and effective treatment while also reducing unplanned accidental extubation. Methods 1. General information: From July 2016 to June 2018, our department treated 77 patients with upper extremity trauma and infection, including 43 males and 34 females. Their ages ranged from 12 to 79 years. The reasons for VAC included 1 case of compartment syndrome, 28 cases of dog bite, 25 cases of open injury, 9 cases of soft tissue infection, 3 cases of postoperative wound nonunion, and 11 cases of postoperative wound infection. Forty-one patients received VAC tubing fixation with conventional methods, including 23 males and 18 females, and their ages ranged from 12 to 71 years (48.32±17.36) years; 36 patients received VAC tubing fixation with sandwich method, including 20 males and 16 females, and their ages ranged from 22 to79 years (55.19±14.27) years. 2. Intervention methods: (1) Conventional tube fixation group. The hydrophobic polyurethane foam dressing was cut during surgery to fit the wound size, including the fistula and ulcer; the sealing membrane was trimmed to completely cover the dressing and the area beyond the edge of the wound 3-5 cm. The operator used the index finger and thumb to pinch the sealing film, cut a small hole in the film to allow the wound to seep through (without opening the dressing) , opened the suction cup, and fixed the suction cup on the sealing film. Finally, the treatment host was connected, and the pressure was set by touching the screen of VAC negative pressure wound therapy device. (2) Sandwich method fixation group. On the basis of the last step of the conventional tubing fixation method, the film was covered on the fixed suction cup and the proximal end of the VAC tube, and the VAC tube was fixed on the corresponding limb with the high lift method. If the suction cup was fixed near the joint, it should be protected by a brace to prevent from falling off due to repeated movement of the joint. 3. Statistical methods: SPSS23.0 statistical software was used to analyze and process the data. The measurement data was expressed as±s; the count data was described by the number of cases and percentage, and the chi-square test was used. A value of P<0.05 was considered significant difference. Results There were no significant differences in gender and age between the two groups (P>0.05) . In the conventional tube fixation group, there were 8 cases of dissociations, 3 cases of sudden position change, 4 cases of postoperative delirium with postoperative sputum self-extraction, and 1 case of patient consciously uncomfortable to pull the tube accidentally. In the sandwich method group, 1 case of unplanned extubation occurred due to the reason of postoperative delirium and inability to corporate with care. There was a statistically significant difference in the unplanned extubation of the two tube fixation methods (P=0.032) . Conclusions The use of the sandwich method to fix the upper limb VAC vacuum suction tube can reduce the incidence of unplanned extubation to a certain extent, and help to reduce the incidence of negative clinical care events, which is worth promoting. Key words: Sandwich method; Vacuum assisted closure; Unplanned extubation; Care

Objective To explore the value of moist therapy for delayed wound healing in patients with liver diseases after surgery. Methods Clinical data of 54 patients undergoing surgical treatments with delayed wound healing in the Third Affiliated Hospital of Sun Yat-sen University from January 2011 to January 2014 were analyzed retrospectively. There were 45 males and 9 females with the age ranging from 24 to 70 years old and a median of 47 years old. All the patients were complicated with liver diseases. The informed consents of all patients were obtained and the ethical committee approval was received. Moist therapy was used in the dressing changing of the delayed healing wounds. After regional and overall assessment, appropriate cleaning solutions were chosen. According to the activity of wound basal lamina, location and patients' coagulation function, mechanical debridement, conservative sharp debridement or autolytic debridement were chosen. Microenvironment which benefited the wound healing was created through exudates management and wound sealing. Different wound dressings such as silver sulphadiazine impregnated hydrocolloid dressing (Urgotul SSD), sodium chloride impregnated dressing (Mesalt), calcium alginate dressing (Sorbalgon), hydrofiber dressing (Aquacel), silver-containing hydrofiber dressing (Aquacel Ag) were chosen and the wounds were dressed and fixed. The causes of delayed wound healing were explored and the wound healing were observed after giving moist therapy. Results The causes of delayed wound healing included subcutaneous fat liquefaction (n=30), incision infection (n=16), subcutaneous hemotoma (n=8). After giving moist therapy for 5 to 21 d, the granulation proliferation of the wounds was observed well in 54 patients. Forty-two cases received second suture and the wounds in 12 cases were compressed and pulled up using 3M steri-strip. All the wounds healed completely with a cure rate of 100%. Conclusions Moist therapy can promote the proliferation of granulation tissues of patients with liver diseases and delayed wound healing after surgery, and provides favorable condition for the secondary healing. Key words: Moist therapy; Liver diseases; Surgical wound infection; Wound healing; Occlusive dressings; Bandages, hydrocolloid

Objective To study the role of the oxidative stress in the development of wound healing and observe the effect of the antioxidant PTD-SOD on damage and inflammation reaction after mechanical wound. Methods In this experiment,acute wound healing model by removal the whole layer dorsal skin of the mice was prepared,SOD(3 000 U and 6 000 U)and the fusion protein PTD-SOD with different concentrations(1 000 U,3 000 U,6 000 U and 10 000 U)were used to deal with the wounds continuously for 13 days.The mice were divided into different concentration SOD treatment group and PTD-SOD treatment group,model control group,physiological saline treatment group and compound iodine solution control group.The wound healing situation and healing percentage of the fight and left skin wounds of each mouse in every group was recorded every day.At day 14 after wound,the wound healing skin of each group was removed and some were used to make 10%tissues homogenate for detecting the activities of superoxide dismutase(SOD),catalase(CAT),glutathione peroxidase(GSH-Px)and contents of malondialdehyde(MDA)and hydroxyproline(Hyp);in the meantime,the other removed skin were fixed in 10% formalin for observing the histopathological changes of the tissues. Results Compared with the model control group,the physiological saline treatment group and the compound iodine solution control group,the skin wound healing percentage was significantly(P<0.05 or P<0.01)improved,with increase of the activities of SOD,CAT,GSH-Px and contents of Hyp (P<0.05 or P<0.01)and decrease of MDA(P<0.05 or P<0.01) in the SOD groups or PTD-SOD groups (except for 10 000 U PTD-SOD group).When compared with the physiological saline treatment group or the compound iodine solution treatment group,the effect was similar to the model control group.In comparison to the SOD groups,under the same dosage and environment condition,the PTD-SOD groups were much better than SOD groups with regard to promoting skin wound healing percentage,increasing activities of antioxidases and contents of Hyp,decreasing contents of MDA.Among the PTD-SOD groups,the effect of high dosage 10 000 U on promoting skin wound healing was declined. Conclusions The oxidative stress may playan important role in the development of wound healing.Proper application of treatment with antioxidants is a alternative strategy in the early stage of wound.PTD-SOD is able to prevent the oxidative stress damage,inhibit inflammatory infiltration and promote skin wound healing efficiently. Key words: Wound healing; Antioxidants; Oxidative stress; Reactive oxygen species

The regeneration of dermis and epidermis in the soft tissue is still challenging in an infected dermal wound healing The protein based biomaterial scaffold acts as a template for an extracellular matrix in the skin Collagen biomaterials enhance healing of well infected and collagen fibres maturation by providing a scaffold for the more rapid transition to mature and aligned collagen fibres production at the wound site Gelatin denatured collagen bears no antigenicity and immunogenicity and can be easily exploited for controlled antimicrobial drug release owing to its degradation by bacterial gelatinase and collagenase present in the infected wound A porous collagen scaffold impregnated with ciprofloxacin loaded gelatin microspheres capable of delivering the drug in initially burst release followed by a controlled manner at the wound site has been developed Ciprofloxacin loaded gelatin microspheres were prepared by water in oil emulsion technique and subsequently impregnated in a collagen scaffold Collagen scaffold contained pores in the size range of micro m that encapsulate gelatin microspheres The degradation of gelatin microspheres at the wound site offers drug release at wound surface and collagen scaffold acts as a reservoir for gelatin microspheres and supports skin regeneration Morphological features of microspheres and microsphere impregnated collagen were analyzed through scanning electron microscopy SEM The SEM micrograph reveals the presence of interconnectivity pores in the scaffold and heterogenous cross sectional structures promoting cell fate process at the site of injury The encapsulation efficiency of the drug in gelatin microspheres is Drug release profile shows that of drug burst released within hours followed by controlled release up to days In vivo studies confirm gelatin microspheres impregnated in collagen scaffold heals full thickness wound created in Albino Wister rats in days whereas antibiotic incorporated collagen sponge and plain collagen scaffold heal full thickness wounds in and days respectively Histological investigation on granulated tissue concludes microspheres incorporated collagen scaffold regenerated the dermis and the epidermis effectively and controls the infection at wound site by observing fewer neutrophils in the th and th day of wound healing Masson rsquo s Trichrome staining reveals the formation of well stretched collagen bundles in the granulated tissue from treated groups and additionally the aldehyde content in the collagen of treated groups increased with the days of wound healing confirming the formation of good crosslinking in the newly synthesized collagen in the regenerated wound The biochemical analysis of granulated tissue from both open and treated wound confirms the microspheres collagen scaffold highly synthesized extracellular components in the tissue concluding microspheres impregnated collagen scaffold would be a synergistic function of regenerating the soft tissue and controlling the infection effectively results as effective wound care system

Objective To explore the healing effect of vacuum sealing drainage (VSD) technique using in treatment of deep burn wound. Methods Patients were selected who hospitalized in our hospital because of burn from June 2014 to May 2016, and divided into the VSD group and silver sulfadiazine (SD-Ag) group. The incidence of wound infection, bacterial culture positive rate and wound visual analogue score (VAS) were compared between two groups of patients in different time after burn, and also compared two groups of patients with wound healing time, and incidence of scar and the scar rating scale of vancouver. Results A total of 80 patients were included in the study, and divided into VSD (n=46) and SD-Ag (n=34) groups. The wound infection rate and bacterial culture positive rate in the VSD group were significantly lower than the SD-Ag group after burn for 7 d, 14 d, and 21 d (P<0.05). Patient's wound pain VAS score in the VSD group was less than SD-Ag group after burn for 7 d, 14 d, and 21 d (P<0.05). The wound healing time, incidence of scar, and vancouver scar table score in the VSD group were significantly lower than that of SD-Ag group (P<0.05). Conclusions The use of vacuum sealing drainage of treatment for burn patients can significantly reduce the wound infection, relieve wound pain, promote wound healing, and reduce scar occurred at the same time. Key words: Negative-pressure wound therapy; Burns/TH; Wound healing

Wound healing is a dynamic and well-ordered biological process, in which re-epithelialization plays an important role. Re-epithelialization of skin wounds depends upon epidermal cells migration from the wound edge. Hypoxia is a microenvironmental stress that occurs immediately after injury, likely due to the vascular disruption and increased oxygen consumption by cells surrounding the wound edge, which has been shown to promote epidermal cells migration and wound healing. Endogenous electric field (EF) is generated instantaneously after injury due to the collapse of the trans-epithelial potentials, which plays an overriding guidance role in directing epidermal cells migration towards the wound center in wound healing. In addition, nitric monoxide (NO) as an inflammatory factor produced after wounds occur has been found to promote epidermal cells migration and wound healing. In conclusion, hypoxia, EF and NO accelerate the healing process though promoting epidermal cells migration towards the wound center. Key words: Cell movement; Wounds and injuries; Wound healing; Nitric oxide; Hypoxia; Electric field

Objective To investigate the clinical effect of multifunctional debridement instrument in the treatment of chronic wounds. Methods Sixty patients with chronic wounds admitted to the Department of Burns, Heilongjiang Provincial Hospital from October 2016 to October 2018 and meeted the inclusion criteria were divided into treatment group and control group according to the random number toble method, 30 cases in each group. After the patients in the control group were properly removed from the wound necrotic tissue, the multifunctional ultrasonic debridement instrument was performed twice a week for 2 weeks and 4 times. The patients in the control group were treated with traditional bedside debridement and changed dressing every other day. The wounds sample of the two groups were taken for examination before and 12 days after the first debridement. The number of wound bacteria, wound bacterial clearance rate and wound DESIGN-R score before and 12 days after the first debridement treatment in the 2 groups were recorded. Data were processed with t test and chi-square test. Results Before the first debridement treatment, Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa were quantitatively detected on the wound surface of the patients in the two groups, the differences were not statistically significant (with P values above 0.05). At 12 days after treatment, there were statistically significant differences in the number of bacterial on the wound surface between the two groups (with P values below 0.05), the bacterial clearance rates of the Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa in the treatment group were (77.66±4.18)%, (76.12±5.14)%, (80.69±4.92)%, (75.95±3.16)%, and the control group were (42.64±2.37)%, (37.14±2.68)%, (27.12±3.17)%, (41.77±2.59)%, the differences were statistically significant (t=5.39, 3.97, 3.87, 5.37; with P values below 0.05). There were no significant differences in the DESIGN-R scores between the two groups before treatment (with P values above 0.05). The total score was (13.60±3.28) points in the treatment group 12 days after treatment, which was (20.33±4.79) points in the control group, the difference between the two groups was statistically significant (t=6.14, P<0.05). Conclusion The multifunctional debridement instrument for ultrasonic debridement has a better clinical effect in treating chronic wounds, which is worthy of clinical treatment. Key words: Wounds and injuries; Debridement; Bacteria; Ultrasonic debridement; Multifunctional debridement instrument; Chronic wounds

Object. The study of the informativeness by various methods of visualizing the dimensions of wound defects and the dynamics of their healing in patients with diabetic foot syndrome (DFS). Materials and Methods . The descriptive research analyzed various methods for determining the size of wounds in 77 patients with DFS. 63 (81.8 %) patients (1st group) were performed classical planimetry by film using. The wound size at 6 (7.8 %) patients (2nd group) was estimated by using a computer program, 8 (10.4 %) patients (3d group) underwent magnetic resonance imaging (MRI) their feet. Results . In the course of the study, the median area of wounds in Group 1 patients were 25.0 [16.2; 44.5] cm2, median depth — 3.3 [1.5; 6.5] cm. It was required about 15–20 minutes of the expert work. The median area of wounds by patients Group 2, measured with the mobile application V2F, was 8.95 [6.8; 10.6] cm2. The depth determined by the same method was 0.25 [0.2; 0.5] cm. The study duration amount to 5 minutes approximately. The 3d patients Group that was measured with MRI had wound defects depth equal to 3.2 [2.6; 4.5] cm, wound area - 23.5 [12.3; 55.3] cm2. This study duration was similar to the standard MRI protocol. Conclusion. The planimetric method of wound size analysis is a routine way for assessing the dynamics of the wound defects state, its size and depth. Determining the size of wounds with special software is rather quick and simple method, but it allows to evaluate only the planar characteristics of the wound and has a high error. The MRI procedure of a wound with an alginate dressing allows to reliably estimate the volume of wound defect and exclude the presence of a hidden infection focus.

In order to discover early vital reactions the authors investigated the changes in the activity of alkaline phosphatase, acid phosphatase and esterase in ante ­ mortem and postmortem skin wounds. Dermal connective tissues adjacent to the wound edge showed a decrease in the activity of the three enzymes from 2 hours after vital wounding. Surround­ ing the decreased zone, along the wound edge, the activit y of the three enzymes increased simultaneously in local fibroblasts from 2 hours and in immigrating leucocytes from 4 hours after vital wounding. The authors consider that these phenomena belong to the intravital reactions, since there were no such changes in postmortem wounds. Epidermis and hair follicles in the vicinity of the wound edge revealed an increased esterase activity as early as 30 minutes after vital wounding. Such a phenomenon was also seen even in postmortem skin wounds which were inflicted within 2 hours after death and preserv ed for a certain time inter val. On a lkaline phosphatase and acid phosphatase, increased reactions in the epidermis and hair follicles could not be observed. It seems that this increase in esterase activity corresponds to the intermediate reactions. Accordingly, whether a wound is of vital origin or not, might not be decided solely by the earlier increase in esterase a ctivity. Further, because of the simultaneous activation of the three enzymes, the estimation of the age of wounds should b e based rather on the intensity and localization of the enzyme activit ies.

Objective To explore clinical effects about surgical operation treatment and non-surgical operation treatment methods for acute infectious diabetic foot moist gangrene wounds, and to provide guidance for treatment of acute infectious diabetic foot moist gangrene wounds. Methods To retrospectively analyze 63 cases of acute infectious diabetic foot moist gangrene patients treated by the Department of Burns, Guangzhou First People′s Hospital from January 2014 to March 2017. According to the clinical situation of acute infectious diabetic foot moist gangrene wounds, the surgical treatment[including debridement surgery and debridement surgery plus negative pressure wound therapy (NPWT)] and non-surgical treatment (including ultrasonic debridement and routine dressing) was performed respectively. The 63 cases were divided into surgical treatment group(44 cases) and non-surgical treatment group(19 cases) on the basis of the differences of treatments. By analyzing the changes of blood glucose before and after wound treatment, the inflammation around the wound, the growth of granulation tissue and the total amputation rate, the clinical effect of different clinical treatment on diabetic foot moist gangrene wound was evaluated. The data were compared by t test, Radit analytical method and chi-square test. Results Both the surgical treatment group and the non-surgical treatment group had obvious blood glucose reduction before and after operation, the difference were statistically significant (with P values below 0.05). In the field of inflammatory reaction and granulation tissue formation, the surgical treatment group had 95%CI in the control of inflammatory reaction (0.808-1.149), and in granulation generation, the following 95%CI was 0.792-1.133, obviously better than non-surgical treatment group, the difference was statistically significant. At the same time, Radit analysis was performed on the debridement surgery and debridement plus NPWT in the surgical treatment group. The results suggested that there was no significant difference in granulation between the two treatment methods. The 95%CI was 0.2466-0.6466. The amputation rate was 9% in the surgical treatment group, and 37% in the non-surgical treatment group, it was suggesting that surgical treatment can significantly reduce the amputation rate, the difference was statistically significant (χ2=5.30, P<0.05). Conclusions For acute infectious diabetic foot moist gangrene wounds, debridement surgery or plus NPWT should be actively performed to remove necrotic tissue as much as possible, actively control infection, and promote granulation growth. That is of great significance for limb salvage treatment of diabetic foot moist gangrene. Key words: Diabetic foot; Gangrene; Negative-pressure wound therapy; Wound treatment; Acute infectivity

Objective To explore gene transcription of stromal cell derived factor-1 (SDF-1) in the derma wound healing in three kinds of different immune state mice. Methods BMSCs were isolated from BALB/C male mice bone marrow and further purified according to the different adhenrence of different kinds of cells to the wall of culture flask. The third generation of BMSCs was used for inducing osteogenesis and adipogenesis. Then, BALB/C,Nude and SCID female mice were transplanted with other third generation of male BMSCs via the tail vein after 3.5 Gy irradiation. The back skin wound was constructed in the bone marrow-chimeric mice in 4 hours after irradiation. A piece of wound tissue was harvested in post-operation 1,3,5,7 and 14 days in order to detect mRNA (messenger RNA) expressions of SDF-1 at different time points by Reverse t ranscription-polymerase chain reaction (RT-PCR) analysis. Results Osteogenesis and adipogenesis could be induced from BALB/C male mice BMSCs in vitro. During wound healing in BALB/C mice,SDF-1 expression began increasing on day 1 after injury,reached the peak level on day 5 (P<0.01) ,and then decreaseded gradually,when wound healing on day 14,SDF-1 level was near to its control group; while SDF-1 expression up-regulated on day 1 after injury in Nude and SCID mice,reached the peak level on day 7(P<0. 01 ) ,then decreaseded gradually, contrasting to BALB/C mice,peaking of SDF-1 was delayed,and their wounds could be healed on day 14,SDF-1 level exceeded their control group. Conclusion SDF-1 can enhance BMSCs mobilization and recruitment in the wound, participate in the period of inflammation and proliferation,and it plays a pivotal role during wound healing; immune function of organism can influence BMSCs recruitment, thus influence wound healing. Key words: Stroma-cell derived factor-1; Tauma and injury; Wound healing; Gene expression

The restoration of functional connective tissue is a major goal of the wound healing process. This regenerative event requires the deposition and accumulation of collagenous and noncollagenous matrix molecules as well as the remodelling of extracellular matrix (ECM) by matrix metalloproteinases (MMPs). In this study, we have utilized substrate gel electrophoresis, radiometric enzyme assays, and Western blot analyses to determine the temporal pattern of appearance and activity of active and latent MMPs and their inhibitors during the entire healing process in a partial thickness wound model. Through the use of substrate gel electrophoresis, we studied the appearance of proteolytic bands whose molecular weight was consistent with their being members of the MMP family of enzymes. Proteolytic bands whose molecular weight is consistent with both the active and latent forms of MMP-2 (72 kDa, Type IV gelatinase) were detected in wound fluid of days 1-7 after wounding. The number of active MMP-2 species detectable in wound fluid was greatest during days 4-6 after wounding. The most prominent proteolytic band detected each day migrated with a molecular weight consistent with it being the latent form of MMP-9 (92 kDa, Type V pro-collagenase). In contrast to MMP-2, the active form of this enzyme was never detected. The presence of MMP-1 (interstitial collagenase) was detected by immunoblot in the wound fluid from days 1-6 post-injury. Using a radiometric enzyme assay for collagenase inhibitory activity we have also determined the time course of activity of endogenous matrix metalloproteinase inhibitors. We have correlated these data to the known cellular events occurring in the wound during this time period as well. This study establishes a prototypical pattern of MMP appearance in normal wound healing. It may also provide potential intervention sites for the therapeutic use of inhibitors of aberrant MMP activities which characterize chronic wounds.

This study was conducted to explore the role of pumpkin seed oil (PSO) ofcucurbitapepo ,as alternative of traditional medicinal treatment for manage wound healing in mice .Firstly, the oil of cucurbitapepo (pumpkin seed oil) obtained by hot extraction method with n-hexane solvent .Forty male Balb- c mice were coetaneous induced surgical wound on the back region bilaterally .Theywere divided into four equal groups and treated topically as following . Group one (G1) treated with pumpkin seed oil, group tow (G2) treated with MEBO, group three (G3) treated with combination of pumpkin seed oil plus MEBO. While group four (G4) didn’t received any treatment and considered as control. Clotting time, platelet count, blood glucose, insulin activity, white blood cells count, red blood cells count, differential white blood cells count, pro thrombin time, thrombin time and fibrinogen level, were assessed after one day of induced wound and after complete wound healing in all experimental animals. The wounds were followed up through measuring their diameters, photographically and histological (through obtaining skin biopsy after 4, 6,8,10daysand so on of incision tillhealing. There were no statisticaldifferences at p<0.05 in clotting time, platelet count, red blood cells count and pro thrombin time between the values measured after one day of incision when compared to the values measured after healing in all experimental groups. The diameter of wounds decreasesi.e. wound healed proportionally with the time of treatment. Histological appearance of the wound of experimentalgroupsexhibited progression in wound healing which was taking4-10 days after treatment. All healed wounds of various groupsshamed decrease in inflammatory cell with collagen infiltration in the dermis and complete regeneration of the epithelial cells in the epidermis.