title: Measurements in wound healing with observations on the effects of topical agents on full thickness dermal incised wounds.
abstract: BACKGROUND
  A multitude of topical wound treatments are used today. Although it is well established that the micro-environment of healing wounds can be altered to improve healing, it is difficult to measure the subtle differences in outcome where therapies are compared.
  
  
  METHODS
  We compared wound healing properties between four different topical agents in surgically incised wounds in a pig model. The four topical agents, 5% Povidone-Iodine cream, 1% Silver-Sulphadiazine, 2% Mupirocin, and 1% Silver-Sulphadiazine plus 1mg/100g recombinant-human epithelial growth factor (EGF) were randomly assigned to four test animals each. Test agents were compared to each other and to untreated controls. We investigated existing and new methodologies of measurement of wound healing: clinical and histological visual scoring systems, immuno-histochemistry, and computerized image analysis of the wounds on days 3, 7, and 28.
  
  
  RESULTS
  All agents were found to have improved healing rates with better cellular architecture. Healing was faster, histological appearance resembled normal architecture sooner, clinical appearance improved, mitotic activity was stimulated and more collagen was deposited in comparison to the wounds with no agents. EGF-treated wounds showed an increased rate of epithelisation, but the rate of healing did not correlate well with evaluation of cosmetic outcome.
  
  
  CONCLUSIONS
  Topical agents improve all aspects of wound healing. The addition of a human recombinant EGF to Silver-Sulphadiazine increases epithelial growth and amounts of collagen in the regenerating wounds at day 7.
authors.affiliation: Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa.
authors.forename: D
authors.initials: D
authors.lastname: Theunissen
authors.affiliation: Department of Anatomical Pathology, Groote Schuur Hospital, NHLS, University of Cape Town, South Africa.
authors.forename: B
authors.initials: B
authors.lastname: Seymour
authors.affiliation: Department of Anatomical Pathology, Groote Schuur Hospital, NHLS, University of Cape Town, South Africa.
authors.forename: M
authors.initials: M
authors.lastname: Forder
authors.affiliation: Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa.
authors.forename: S G
authors.initials: SG
authors.lastname: Cox
authors.affiliation: Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa. Electronic address: heinz.rode@uct.ac.za.
authors.forename: H
authors.initials: H
authors.lastname: Rode
mesh_terms: D000279:Administration, Cutaneous; D000818:Animals; D000890:Anti-Infective Agents / Q000494:pharmacology*; D002056:Burns / Q000188:drug therapy* / Q000473:pathology; D049109:Cell Proliferation / Q000187:drug effects; D020405:Dermis / Q000187:drug effects / Q000473:pathology; D004815:Epidermal Growth Factor / Q000494:pharmacology*; D004817:Epidermis / Q000187:drug effects / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007150:Immunohistochemistry; D016712:Mupirocin / Q000494:pharmacology*; D011206:Povidone-Iodine / Q000494:pharmacology*; D062326:Re-Epithelialization / Q000187:drug effects; D011994:Recombinant Proteins / Q000494:pharmacology; D012837:Silver Sulfadiazine / Q000494:pharmacology*; D012867:Skin / Q000187:drug effects* / Q000473:pathology; D013552:Swine; D015599:Trauma Severity Indices; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000890:Anti-Infective Agents; D011994:Recombinant Proteins; D004815:Epidermal Growth Factor; D011206:Povidone-Iodine; D016712:Mupirocin; D012837:Silver Sulfadiazine
keywords: Computer image analysis; Epithelial growth factor; Porcine model; Topical agents; Wound healing