Role of topical Sucralfate in healing of burn wounds

Authors

  • Mahim Koshariya Department of Surgery, Gandhi Medical College and Hamidia Hospital Bhopal, Madhya Pradesh, India
  • Abhishek Shitole Department of Surgery, Gandhi Medical College and Hamidia Hospital Bhopal, Madhya Pradesh, India
  • Vibhore Agarwal Department of Surgery, Gandhi Medical College and Hamidia Hospital Bhopal, Madhya Pradesh, India
  • S. Dave Department of Surgery, Gandhi Medical College and Hamidia Hospital Bhopal, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20183409

Keywords:

Silver sulfadiazine, Sucralfate, Wound healing

Abstract

Background: Sucralfate is a basic aluminum salt of sucrose octasulphate which was orally taken for prevention and treatment of several gastrointestinal diseases. This study primarily aims to analyze whether sucralfate accelerates wound healing process in burn patients. The incidence of infection & relieve in pain in burn patients was also compared.

Methods: This is an observational study carried out in the Department of General Surgery, Hamidia Hospital Bhopal on 50 patients divided into group 1 (sucralfate)and group 2 [a-sucralfate; b-silver sulfadiazine (SSD)]. Demographics, history, physical, and systemic examinations of the patients were recorded.

Results: It was observed that sucralfate augments the formation of granulation tissue (in 6-17 days) as compared to SSD (14-22 days). It was noticed that faster healing by re-epithelialization was present in sucralfate group (11-22 days) as compared with SSD group (15-30 days). By the end of 3rd week 50-75% of wound was healed in sucralfate group as compared with 35-50% in SSD group. Incidence of secondary infection was less when topical sucralfate was used (group 1 = 25%; group 2a = 16.6%; group 2b = 66.66%). There was a marked relief in pain and discomfort after sucralfate application as compared to SSD.

Conclusions: Using topical sucralfate expedite the burn wound healing process, significantly decreases pain with no local or systemic adverse reactions to the topical application therefore it can be used as an adjunctive or alternative agent in the future. However, multicentric trials with larger sample size are needed to insure the concept.

References

Illingworth C, Dick BM. Response to injury. Text book of surgical pathology. 10th ed. London: Churchill; 1968;2:26.

Artz, Curtis P, Eric. Treatment of burns. 1st ed. W. B. Saunders Co. Philadelphis; 1957:250.

Evans EI, Purnell OJ, Robinett PW, Batchelor A, Martin M. Fluid and electrolyte requirements in severe burns. Ann Surg. 1952;135(6):804-15.

Chen RW. Biochemistry of wound healing monograph. Surg Sci. 1964;1:215.

Burch RM, Millan BA. Sucralfate induces proliferation of dermal fibroblasts and keratinocytes in culture and granulation tissue formation in full tiickness skin wound. Agents Action. 1991;34(2):22-31.

Chen BW. Effect of sucralfate on gastric mucosal blood flow in rats. Gut.1989;30:1544-51.

Danesh BJZ. Effect of intragastric PH on mucosal protective action of sueralfate. Gut. 1988:29:1379-85.

Danesh BJZ, Duncan A, Russell RI. Is an acid pH medium required for the protective effect of sucralfate, against mucosal injury. Am J Med. 1987;83(38):11-3.

Marks IN, Samloff IM. Sucralfate in peptic ulcer disease and gastritis; a worldwide view. Am J Med. 1985;79(2C):1-64.

Richardson CT. Sucralfate. Ann Internal Med. 1982;97(2):269-72.

McMillan MD. Infections in burns. J Burn Care Res. 2012;33.

Dai T, Huang YY, Sharma SK, Hashmi JT, Kurup DB, Hamblin MR. Topical antimicrobials for burn wound infections. Recent Pat Antiinfect Drug Discov. 2010;5(2):124-51.

Pfeiffer P, Hansen O, Madsen EL, May O. A prospective pilot study on the effect of sucralfate mouth-swishing in reducing stomatitis during radiotherapy of the oral cavity. Acta Oncologica. 1990;29(4):471-3.

Szabo S, Hollander D. Pathways of gastroduodenal protection and repair mechanisms of action of sucralfate. Am J Med. 1989;86(6A):23-31.

Szabo S, Vattay P, Scarbrough E, Folkman J. Role of vascular factors, including angiogenesis, in the mechanisms of action of sucralfate. Am J Med. 1991;91(2):S158-60.

Taranwski A, Hollander D. The mechanism of Trotective, therapeutic and prophylactic action of sucralfate. Scand J Gastroenterol. 1987;22(140):7-13.

Tarnawski A, Hollander D, Gergely H. Sucralfate: a topical cytoprotective agent: mechanisms of protective, therapeutic, and prophylactic actions. In: Gastric protection. Raven Press, New York; 1988:247-251.

Szabo S. The mode of action of sucralfate: the 1 × 1 × 1 mechanism of action. Scand J Gastroenterol Suppl. 1991;185:7-12.

Yoshida N, Terao N, Nagashima R. Sucralfate a basic aluminum slat of sucrose sulfate. Arzneim Forsch. 1980;301:78-80.

Hayashi AH, Lau HYC, Gillis DA. Topical sucralfate: effective therapy for the management of resistant peristomal and perineal excoriation. J Pediatr Surg. 1991;26(11):1279-81.

Burch RM, McMillan BA. Sucralfate induces proliferation of dermal fibroblasts and keratinocytes in culture and granulation tissue formation in full-thickness skin wounds. Agents and Actions. 1991;34:229-31.

Downloads

Published

2018-08-25

Issue

Section

Original Research Articles