THE EFFECT OF BINJAI (Mangifera caesia) LEAVES EXTRACT GEL TO FIBROBLAST CELL NUMBER ON INCISION WOUND

Background: The ethanol extract of binjai leaves contains bioactive compounds that are saponin, tannin, triterpenoid, steroid, alkaloid and flavonoid which potentially as an anti-inflammation, anti-bacterial, and antioxidant. It can fasten and control the process of scar healing. The binjai leaves extract was made into gel preparation. The binjai leaves extract gel can affect fibroblast cell number during the proliferation phase. Purpose: To analyze the effect of binjai (Mangifera caesia) leaves extract gel to the fibroblast cell number on male wistar rats (Rattus norvegicus) incision wound. Methods: This research design was a true laboratory experimental research with post-test only with control group design which used 24 male wistar rats and divided into 4 groups: the negative control group that was given the placebo gel and the treatment group that was given the binjai leaves extract gel with 5%, 10%, and 15% concentrations. Results: The result of Two-way ANOVA statistic test shows that there is a meaningful difference in the treatment group on the 7th day (p=0,000) and on the 14th day (p=0,000). The Post-Hoc Bonferroni test for fibroblast cell number on the 7th and 14th day shows that there is a meaningful difference (p<0,05) between the negative control group and the treatment group. Conclusion: Binjai leaves extract gel have an effect to the fibroblast cell number on male wistar rats incision wound with the most effective concentration of 15%. Keywords: Binjai leaves extract gel, Fibroblast cell number, Flavonoid, Incision wound healing

EP.FRI.489 Audit of emergency Operation notes (audit cycle)

The Royal College of surgeons has recommended guidelines for documenting operative surgical notes. An operation note must include ample information about the operation. In our initial audit, we found some areas for improvement. This re-audit of operative notes was aimed to review compliance with the guidelines by the Royal College of Surgeons and to identify areas of further improvement. Methods The notes of all patients who underwent emergency surgery from 1st of January to 15th of March 2020 under the General Surgical department were reviewed. Endoscopic procedures were not included in the study. Electronic records were used to review the operation notes. Results Notes of a total of 176 patients were included in the study. Significant improvement was seen in most of the domains. Compliance of 100% was seen in documenting operative findings, type of incision, wound closure technique, procedural details, documenting extra procedures, and post operative instructions. 17.6% notes did not clearly document the indication/diagnosis for surgery. 15.3% notes missed information about DVT prophylaxis. 25.57%notes did not include information about peri-operative antibiotics in the context of prophylaxis or post-op need. A significant number (71.6% ) of the notes were missing information about operative blood loss if there was any or none. Conclusion Overall operation notes detail most of the information expected by the Royal College of Surgeons. The key areas for improvement are to include specific details about the following:

DEVELOPMENT OF HERBOMINERAL FORMULATION FROM DAUCUS CAROTA (LINN) FOR WOUND HEALING EFFECTS

A herbomineral formulation was developed in ointment form by using herb extract, mineral and other excipients and evaluated for wound healing effect in excision and incision wound models in rats. Excision wounds sized 500 mm2 and 2 mm depth were used to study the rate of contraction of wound and epithelialization at different time intervals. Incision wounds were used for the study of tensile strength measured on the 10th day. It was observed that the herbomineral formulation in the excision wound model possessed a significant (p<0.001) wound healing effect compared to a positive control group and was nearly comparable with a standard group. In incision wounds, the formulation showed a significant increase in the skin breaking strength compared to control and reference standards.The wound healing effect of the formulation may be attributed to phytoconstituents like flavonoid and phenolic derivatives present in the root extract.The herbomineral ointment was also evaluated for various pharmaceutical parameters and was found to be stable for 45 days.

Incision Wound Healing Test of Ethanolic Extract Gel from Salaon (Parsonsia alboflavescens [Dennst.] Mabb.) Leaves in Male Rats

BACKGROUND: An incision wound is a wound caused by a sharp object. One of the plants that can be used as a traditional medicine for an incision wound is salaon leaves. The prepared form chosen is the gel because it is easy to use and its distribution is faster on the skin. AIM: The aim of the study was to explore whether salaon leaf extract gel meets the quality evaluation requirements and to know the effectiveness of ethanol extract gel of salaon (Parsonsia alboflavescens [Dennst] Mabb.) leaves to cure a scar on male rats. METHODS: Experimental method with salaon leaves as sample. Simplicia of salaon leaves extracted by maceration method, and then arenga gum gel-based formulation, afterward evaluation, and testing of its effectiveness on the healing of incision wound of male rats. Normal data were analyzed by the One Way Analysis of variance (ANOVA) and Post Hoc Tuckey Method. Kruskal-Wallis test used for abnormal data. RESULTS: The whole formula shows homogenous results, normal pH, stability, dissemination and good viscosity, less irritating, and with good adhesion. The results of a statistical analysis of the wound on the 8th day with ANOVA test indicate a significant difference between the five groups p = 0.000 (p < 0.05) and Post-Hoc Tukey Honest Significant Difference test results obtained a concentration of 5% not significantly different from the positive control Placenta extract gel. The optimum dose that can heal incision wound in male rats is 5%. CONCLUSION: The whole formulation qualifies for the quality of the gel formulation. Ethanol extract gel of salaon leaves can heal wound on male rats and the optimal dose is 5%.

Evaluation of in vivo Wound Healing Activity of Ursolic Acid Rich Chloroform Extract of Hedyotis herbacea Linn Ointment

Aim: This study evaluates the effect of in vivo wound healing potential of Ursolic acid rich chloroform extract of Hedyotis herbacea Linn ointment using incision and excision wound model. Study Design: Wound healing potentials of Hedyotis herbacea were analysed by Incision and excision wound model. Place of Study: Nandha College of Pharmacy, Erode, Tamilnadu. Methodology: Hedyotis herbacea was subjected to extraction (cold maceration), with solvents of increasing polarity. All the extracts were estimated for the presence of phytoconstituents by HPTLC. As the study has been focused on the phytoconstituent based biological activity, the Ursolic acid rich chloroform extract was chosen for the study of wound healing activity. The Chloroform extract of Hedyotis herbacea was incorporated into ointment base, to prepare the ointment. The ointments prepared with Chloroform extract (2.5% and 5%) of Hedyotis herbacea (CEHH) were subjected for evaluation of excision and incision wound model. Wistar albino rats were divided into four groups each consisting of six animals; group I (left untreated) considered as untreated control, group II treated with 5% w/w povidone-iodine ointment served as standard, group III treated with CEHH 2.5% w/w ointment, and group IV treated with CEHH 5% w/w ointment were considered as test groups. All the treatments were given once daily. Wound healing effect was assessed by the rate of wound contraction, level of total protein, Hydroxy proline, Hexosamine and Hexuronic acid and histopathology studies in an excision wound model. Tensile strength was also measured in both excision and incision wound. Results: Wound healing activity of CEHH 5% w/w ointment treated group was greater than CEHH 2.5% w/w and untreated groups in both excision and incision wound model. The high rate of wound contraction (*P< 0.001), high tensile strength (*P< 0.001), and elevated total protein, Hydroxyproline, Hexosamine, and Hexuronic acid content were observed in animals treated with CEHH ointments when compared to the untreated control group of animals. Histopathological studies of the CEHH ointments treated groups also revealed the effectiveness in wound healing. Conclusion: These results justified the claimed traditional use of the Hedyotis herbacea as wound healing plant.

Effect of Jatropha Sap (Jatropha curcas Linn.) on Incision Wound Healing in Female Mice (Mus musculus)

Jatropha as a medicinal plant has been very widely used. Among them can cure rheumatic joints, tetanus, epilepsy, and bronchitis in children. Jatropha sap can be used as an antimicrobial, relieves wound bleeding, treats digestive disorders, and treats mouth sores and toothaches. Many people still use traditional medicine to treat wounds. One that is used to treat wounds is jatropha sap. This study aims to determine the effect of the incision wound healing in mice (Mus Musculus) by giving Jatropha sap (Jatropha curcas, Linn) seen from the disappearance of inflammation dryness wounds and the tightening of the skin. This study uses a descriptive method through laboratory tests. Based on the study results, it is known that Jatropha sap has the effect of healing incise wounds in female mice, seen from the elimination of inflammation, drying of the wounds to the closure of the skin (granulation) compared to negative controls.

Effect of Self-care Training Program on Surgical Incision Wound Healing in Women Undergoing Cesarean Section: A Quasi

Background: Cesarean section is one of the most important and common surgeries, and surgical incision wound disorders are one of the medical problems. Self-care behaviors can be effective in accelerating the wound healing process. Objectives: This study was conducted to determine the effect of a self-care training program on surgical incision wound healing in women undergoing cesarean section. Methods: This study was a quasi-experimental clinical trial on 72 women undergoing cesarean section in 2017 at one of the medical centers of Sarpol-e Zahab. Sampling was continuous, and subjects were randomly assigned to control or intervention groups based on inclusion criteria. The mothers of the experimental group were given a surgical wound care booklet, and the contents were taught by the researcher in 45 - 60 minutes one day before cesarean section. The learning rate was measured before and after the intervention at the clinic. Cesarean section wound healing was assessed 24 hours and nine days after cesarean section using REEDA tools in both groups. The collected information was analyzed by statistical indices (standard deviation and mean) and tests (independent t-test, Fisher's exact test, Wilcoxon and Friedman tests) by using IBM SPSS software version 20. Results: The mean score of cesarean section wound healing 24 hours after surgery was 1.1 ± 39.38 in the intervention group and 1.1 ± 92.60 in the control group that had no significant differences (P < 0.13). However, the mean score of cesarean section wound healing nine days after surgery was 0.0 ± 53.65 in the intervention group and 1.1 ± 43.28 in the control group, which showed a significant difference (P = 0.001). Conclusions: According to the findings, it can be concluded that a self-care training program is effective in accelerating the surgical incision wound healing in women undergoing cesarean section. Thus, we propose to use this self-care training program in pregnant mothers undergoing cesarean section.

Potential of Sodium Alginate in Sargassum sp. in Lotion Preparation to Treat Incision Wound in Mice

Sargassum sp. is a known genus of brown seaweed whose dominant component is alginic acid or alginate. Various studies found that alginate having proinflammatory activity, so it may have potential to improve the wound healing process. This study aimed to obtain sodium alginate extract and to know the potency of the sodium alginate extract in incision wound treatment in mice abdomen. Lotion application was performed once a day in a span of five consecutive days. Observation on the wound was carried out to obtain data on blood coagulation, tissue reparation, and fibroblast development rate on the wound using histology. The results showed that the average yield from the Sargassum sp. extraction process was 31.3%. Quality control of the prepared lotion included organoleptic test; light brown coloration, lotion specific odor, semi- solid texture. The acidity of the lotion was measured as 6.61 with 6.731 cp of viscosity. The lotion adhesiveness test showed 0.21 seconds and the lotion was shown to be oil-in-water. Application of the lotion on incision wounds made in the abdomen of rats showed blood coagulation on the first day and onset of wound reparation process on the second day. Wound observation by the third day showed that the inflicted area had undergone a near-complete reparation. The study also showed that on the fifth day of reparation Sargassum sp. extract lotion treatment group showed fibroblast formation, as opposed to the non-extract lotion treatment group. Previous study use alginates as wound dressing material, but in this study alginate used as active ingredient in wound healing treatment. Therefore, this study concludes that sodium alginate in Sargassum sp. seaweed has a potential application in the field of medicine.

Xylocarpus granatum Mangrove Fruit Extract and Sodium Alginate Extract Lotion as Potent Wound Treatment Medicine

A preliminary study to gauge the antimicrobial potency of Xylocarpus granatum mangrove fruit extract and sodium alginate extract against pathogenic microbe from the species Pseudomonas aeruginosa and Staphylococcus epidermidis. Lotions made of mangrove fruit extract (Sample 1) lotion and of a mixture of fruit extract and sodium alginate extract lotion (Sample 2) were topically tested on incision cut wound on mice abdominal area. The lotion was applied daily for five consecutive days. Observation on the test subjects were conducted to determine the rate of blood agglutination, tissue recovery rate, and fibroblast development rate using histology. The results showed that X. granatum extract lotion displayed significant antimicrobial activity against both pathogenic microbe species and did not show any conflict with the microbial activity found in sodium alginate lotion. Lotion adhesiveness test measured sample 1 at 0.26 seconds and sample two at 0.16 seconds. Both samples were shown to be oily in water. Subject observation showed blood coagulation on the first day, onset of tissue recovery on the second day and by the third day the wound had undergone complete tissue recovery. Observation on the fifth day showed that fibroblast tissue on the subject with sample 2 treatment was more solid than that with sample 1 treatment. It was concluded that the mix of X. granatum mangrove fruit and sodium alginate extracts showed most potency in wound treatment.Key words: X. granatum; incision wound; lotions; skin; histology; fibroblast.