title: Effects of topical Kiwifruit on healing of neuropathic diabetic foot ulcer.
abstract: BACKGROUND
  Kiwifruit (Actindia Deliciosa) is demonstrated to have antibacterial and pro-angiogenic effects. It also contains proteolytic enzymes (actinidin) and ascorbic acid. In this study, the effects of Kiwifruit on neuropathic diabetic foot ulcer healing in clinical settings were evaluated.
  
  
  METHODS
  In this randomized clinical trial of 37 patients (17 in experimental and 20 in control groups) with neuropathic diabetic foot ulcer were studied in Isfahan-Iran. Patients of the control group received just the standard treatments. In the experimental group, in addition to the standard treatments, ulcers were dressed with pure extract of kiwifruit twice daily for 21 days. The ulcers were examined and evaluated based on macroscopic, microscopic and microbiological status. Pre- and post-interventions, biopsies were taken from the ulcers to perform microbiological and histological studies.
  
  
  RESULTS
  Mean reduction in surface area of foot ulcer in the experimental group was significantly higher than the control group (168.11 ± 22.31 vs. 88.80 ± 12.04 mm(2) respectively, P < 0.0001). The amount of collagen and granulation tissues was significantly higher in the experimental groups than the control group (P value < 0.0001). Significantly higher levels of angiogenesis and vascularization were found in the kiwifruit treated patients (P value < 0.0001). No significant antibacterial effect was observed for kiwifruit.
  
  
  CONCLUSIONS
  Natural compounds in the kiwifruit including protein-dissolving enzymes (Actinidin) improved different aspects of the wound healing process. Based on these benefits and safety aspects, we conclude that using kiwifruit is a simple, applicable and effective way for treatment of neuropathic diabetic foot ulcer.
authors.affiliation: Department of Thoracic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Mohajeri
authors.affiliation: Department of Thoracic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masumeh
authors.initials: M
authors.lastname: Safaee
authors.affiliation: Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohamad Hossein
authors.initials: MH
authors.lastname: Sanei
keywords: Diabetic foot; diabetic foot ulcer; fruit; kiwifruit; wound healing