title: Bismuth subgallate/borneol (suile) is superior to bacitracin in the human forearm biopsy model for acute wound healing.
abstract: BACKGROUND
  The human forearm biopsy model can evaluate the effect of novel agents on acute wounds. Bismuth subgallate/borneol (Suile) is a new product cleared by the Food and Drug Administration for treating partial-thickness wounds. Anecdotal reports suggest that Suile may be effective for full-thickness wounds because of its antimicrobial and hemostatic properties.
  
  
  METHODS
  In a randomized, investigator-blinded study, 20 normal healthy volunteers underwent 2 6-mm full-thickness skin punch biopsies on the flexor surface of each forearm (2 wounds per subject). Biopsies were randomly assigned to control (bacitracin) and test article (Suile). Wounds were examined, measured by digital planimetry, and photographed daily until healed. Adverse events and pain levels were monitored. Time-to-complete closure was determined.
  
  
  RESULTS
  Direct quantitative and qualitative comparisons of wound healing were made. The Suile group trended strongly toward more rapid healing (log-rank analysis). Individual subject arm analysis identified which biopsies healed first. Suile-treated biopsies healed more rapidly (P = .03, paired t-test).
  
  
  CONCLUSIONS
  Although this study was powered to demonstrate equivalence, convincing evidence indicates that Suile is superior to bacitracin in this model. Based on the results, future studies in full-thickness wounds with Suile are warranted. The biopsy model provides these advantages: direct comparison within subjects, rapid study completion, good patient compliance, and experience with products before embarking on larger clinical trials in wounds.
authors.affiliation: Gannon University, Erie, PA, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Serena
authors.forename: Laura K S
authors.initials: LK
authors.lastname: Parnall
authors.forename: Carrie
authors.initials: C
authors.lastname: Knox
authors.forename: Julia
authors.initials: J
authors.lastname: Vargo
authors.forename: Amanda
authors.initials: A
authors.lastname: Oliver
authors.forename: Sarah
authors.initials: S
authors.lastname: Merry
authors.forename: Andrew
authors.initials: A
authors.lastname: Klugh
authors.forename: Nicole
authors.initials: N
authors.lastname: Bubar
authors.forename: Neil
authors.initials: N
authors.lastname: Anderson
authors.forename: Lynn
authors.initials: L
authors.lastname: Rieman
authors.forename: Wade
authors.initials: W
authors.lastname: Walnoha
authors.forename: Holly
authors.initials: H
authors.lastname: Smith
authors.forename: Samantha
authors.initials: S
authors.lastname: Rice
mesh_terms: D000287:Administration, Topical; D000328:Adult; D001707:Biopsy, Needle; D001729:Bismuth / Q000494:pharmacology*; D001892:Camphanes / Q000494:pharmacology*; D002254:Carbonates; D005260:Female; D005542:Forearm; D006801:Humans; D008297:Male; D009824:Ointments; D016037:Single-Blind Method; D012867:Skin / Q000187:drug effects* / Q000293:injuries*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D001892:Camphanes; D002254:Carbonates; D009824:Ointments; C022871:isoborneol; C028508:bismuth subcarbonate; D001729:Bismuth