Topical 5% potassium permanganate solution accelerates the healing process in chronic diabetic foot ulcers

Eobania vermiculata whole-body muscle extract-loaded chitosan nanoparticles enhanced skin regeneration and decreased pro-inflammatory cytokines in vivo

BACKGROUND

Usually, wounds recover in four to six weeks. Wounds that take longer time than this to heal are referred to as chronic wounds. Impaired healing can be caused by several circumstances like hypoxia, microbial colonization, deficiency of blood flow, reperfusion damage, abnormal cellular reaction and deficiencies in collagen production. Treatment of wounds can be enhanced through systemic injection of the antibacterial drugs and/or other topical applications of medications. However, there are a number of disadvantages to these techniques, including the limited or insufficient medication penetration into the underlying skin tissue and the development of bacterial resistance with repeated antibiotic treatment. One of the more recent treatment options may involve using nanotherapeutics in combination with naturally occurring biological components, such as snail extracts (SE). In this investigation, chitosan nanoparticles (CS NPs) were loaded with an Eobania vermiculata whole-body muscle extract. The safety of the synthesized NPs was investigated in vitro to determine if these NPs might be utilized to treat full-skin induced wounds in vivo.

RESULTS

SEM and TEM images showed uniformly distributed, spherical, smooth prepared CS NPs and snail extract-loaded chitosan nanoparticles (SE-CS NPs) with size ranges of 76-81 and 91-95 nm, respectively. The zeta potential of the synthesized SE-CS NPs was - 24.5 mV, while that of the CS NPs was 25 mV. SE-CS NPs showed a remarkable, in vitro, antioxidant, anti-inflammatory and antimicrobial activities. Successfully, SE-CS NPs (50 mg/kg) reduced the oxidative stress marker (malondialdehyde), reduced inflammation, increased the levels of the antioxidant enzymes (superoxide dismutase and glutathione), and assisted the healing of induced wounds. SE-CS NPs (50 mg/kg) can be recommended to treat induced wounds safely. SE was composed of a collection of several wound healing bioactive components [fatty acids, amino acids, minerals and vitamins) that were loaded on CS NPs.

CONCLUSIONS

The nanostructure enabled bioactive SE components to pass through cell membranes and exhibit their antioxidant and anti-inflammatory actions, accelerating the healing process of wounds. Finally, it is advised to treat rats' wounds with SE-CS NPs.

Potassium permanganate use in the management of a wound induced by contact with Paederus: A case report

Pederin is a vesicant toxic amide, found in the hemolymph of the beetle genus, Paederus. Physical contact with these insects produces a type of irritant dermatitis with variable clinical symptoms. It has been identified that Pederin (a vesicant toxic amide responsible for the ulcerative lesion) is produced by Gram-negative endosymbiotic bacteria of the Pseudomonas genus. The present study describes the case of a patient who had come into contact with the insect Paederus sp. and developed an ulcerative lesion. He was first treated with topical steroids, as part of the conventional management, and following no response to treatment, he was treated locally with a 5% potassium permanganate solution, in conjunction with systemic antibiotic therapy, obtaining a good response in the healing process. On the whole, the present study demonstrates that potassium permanganate solutions, in conjunction with antibiotics and anti-inflammatories, may be beneficial in the treatment of dermatitis or ulcerative lesions caused by insects of the Paederus genus. However, further research is required to fully determine the complete benefits and any side-effects.

Australian guideline on wound healing interventions to enhance healing of foot ulcers: part of the 2021 Australian evidence-based guidelines for diabetes-related foot disease

Background

Diabetes-related foot ulceration (DFU) has a substantial burden on both individuals and healthcare systems both globally and in Australia. There is a pressing need for updated guidelines on wound healing interventions to improve outcomes for people living with DFU. A national expert panel was convened to develop new Australian evidence-based guidelines on wound healing interventions for people with DFU by adapting suitable international guidelines to the Australian context.

Methods

The panel followed National Health and Medical Research Council (NHMRC) procedures to adapt suitable international guidelines by the International Working Group of the Diabetic Foot (IWGDF) to the Australian context. The panel systematically screened, assessed and judged all IWGDF wound healing recommendations using ADAPTE and GRADE frameworks for adapting guidelines to decide which recommendations should be adopted, adapted or excluded in the Australian context. Each recommendation had their wording, quality of evidence, and strength of recommendation re-evaluated, plus rationale, justifications and implementation considerations provided for the Australian context. This guideline underwent public consultation, further revision and approval by ten national peak bodies.

Results

Thirteen IWGDF wound healing recommendations were evaluated in this process. After screening, nine recommendations were adopted and four were adapted after full assessment. Two recommendations had their strength of recommendations downgraded, one intervention was not currently approved for use in Australia, one intervention specified the need to obtain informed consent to be acceptable in Australia, and another was reworded to clarify best standard of care. Overall, five wound healing interventions have been recommended as having the evidence-based potential to improve wound healing in specific types of DFU when used in conjunction with other best standards of DFU care, including sucrose-octasulfate impregnated dressing, systemic hyperbaric oxygen therapy, negative pressure wound therapy, placental-derived products, and the autologous combined leucocyte, platelet and fibrin dressing. The six new guidelines and the full protocol can be found at: https://diabetesfeetaustralia.org/new-guidelines/

Conclusions

The IWGDF guideline for wound healing interventions has been adapted to suit the Australian context, and in particular for geographically remote and Aboriginal and Torres Strait Islander people. This new national wound healing guideline, endorsed by ten national peak bodies, also highlights important considerations for implementation, monitoring, and future research priorities in Australia.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13047-022-00544-5.

Polylactide/Polyvinylalcohol-Based Porous Bioscaffold Loaded with Gentamicin for Wound Dressing Applications

This study explores the feasibility of modifying the surface liquid spraying method to prepare porous bioscaffolds intended for wound dressing applications. For this purpose, gentamicin sulfate was loaded into polylactide-polyvinyl alcohol bioscaffolds as a highly soluble (hygroscopic) model drug for in vitro release study. Moreover, the influence of inorganic salts including NaCl (10 g/L) and KMnO4 (0.4 mg/L), and post-thermal treatment (T) (80 °C for 2 min) on the properties of the bioscaffolds were studied. The bioscaffolds were characterized by scanning electron microscopy, Fourier Transform infrared spectroscopy, and differential scanning calorimetry. In addition, other properties including porosity, swelling degree, water vapor transmission rate, entrapment efficiency, and the release of gentamicin sulfate were investigated. Results showed that high concentrations of NaCl (10 g/L) in the aqueous phase led to an increase of around 68% in the initial burst release due to the increase in porosity. In fact, porosity increased from 68.1 ± 1.2 to 94.1 ± 1.5. Moreover, the thermal treatment of the Polylactide-polyvinyl alcohol/NaCl (PLA-PVA/NaCl) bioscaffolds above glass transition temperature (Tg) reduced the initial burst release by approximately 11% and prolonged the release of the drug. These results suggest that thermal treatment of polymer above Tg can be an efficient approach for a sustained release.

Analytical Applications of Permanganate as an Oxidant in the Determination of Pharmaceuticals Using Chemiluminescence and Spectrophotometry: A Review

Background:

Potassium permanganate is a green and versatile industrial oxidizing agent. Due to its high oxidizing ability, it has received considerable attention and has been extensively used for many years for the synthesis, identification, and determination of inorganic and organic compounds.

Objective:

Potassium permanganate is one of the most applicable oxidants, which has been applied in a number of processes in several industries. Furthermore, it has been widely used in analytical pharmacy to develop analytical methods for pharmaceutically active compounds using chemiluminescence and spectrophotometric techniques.

Results:

This review covers the importance of potassium permanganate over other common oxidants used in pharmaceuticals and reported its extensive use and analytical applications using direct, indirect and kinetic spectrophotometric methods in different pharmaceutical formulations and biological samples. Chemiluminescent applications of potassium permanganate in the analyses of pharmaceuticals using flow and sequential injection techniques are also discussed.

Conclusion:

This review summarizes the extensive use of potassium permanganate as a chromogenic and chemiluminescent reagent in the analyses of pharmaceutically active compounds to develop spectrophotometric and chemiluminescence methods since 2000.

Successful treatment with oral methylprednisolone and cyclosporine for refractory pyoderma gangrenosum in children: Report of a case and review of the literature

We reported the successful treatment with oral methylprednisolone and cyclosporine in combination with topical wound care on a boy with pyoderma gangrenosum presenting as huge and deep ulceration on buttocks and legs.