title: Comparison of Systemic and Topical Hypericum Perforatum on Diabetic Surgical Wounds.
abstract: BACKGROUND
  Surgical wounds in diabetic patients still remain a problem till the present day. As a common plant found around the world, Hypericum perforatum L. (Hypericaceae) is traditionally prepared as an oily extract and used as a folk remedy for various diseases such as wounds, burns, cuts, etc. This study aims to evaluate the effect of St. John's wort (Hypericum perforatum) on problematic wounds while comparing oral and topical applications.
  
  
  METHODS
  Incisional and excisional wound models were made on the dorsal regions of 54 diabetic Spraque-Dawley rats. The rats were divided into the following six groups (n = 9): Group 1: control, Group 2: diabetic, Group 3: diabetic oral Hypericum perforatum, Group 4: diabetic topical Hypericum perforatum, Group 5: diabetic oral olive oil, and Group 6: diabetic topical olive oil.
  
  
  RESULTS
  Groups 3 and 4 had significantly higher tensile strength, tissue hydroxyproline concentration, and collagen density compared with Group 2. Inflammatory cell density and collagen density on day 3 were significantly higher in Groups 3 and 6 compared with Group 2. On day 21, Groups 3 and 6 had significantly higher fibroblastic activity compared with Group 2.
  
  
  CONCLUSIONS
  This study has proved that oral St. John's wort has more positive effects on problematic wounds compared with topical St. John's wort and olive oil, which is a vehicle. Hypericum perforatum results with faster inflammatory response and better healing. These results could be an addition to literature about the clinical usage of Hypericum perforatum on diabetic wounds.
authors.affiliation: a Muğla Sitki Koçman University, Faculty of Medicine, Department of Plastic , Reconstructive and Aesthetic Surgery , Muğla , Turkey.
authors.forename: Mehmet
authors.identifier: http://orcid.org/0000-0002-9971-7137
authors.initials: M
authors.lastname: Altıparmak
authors.affiliation: b Erciyes University, Faculty of Medicine, Department of Plastic , Reconstructive and Aesthetic Surgery , Kayseri , Turkey.
authors.forename: Teoman
authors.initials: T
authors.lastname: Eskitaşçıoğlu
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000818:Animals; D003921:Diabetes Mellitus, Experimental / Q000139:chemically induced / Q000503:physiopathology*; D006801:Humans; D020902:Hypericum / Q000737:chemistry*; D000069463:Olive Oil / Q000494:pharmacology / Q000627:therapeutic use; D010936:Plant Extracts / Q000494:pharmacology / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012867:Skin / Q000503:physiopathology; D000072836:Surgical Wound / Q000188:drug therapy*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
chemical_list: D000069463:Olive Oil; D010936:Plant Extracts
keywords: Hypericum perforatum; St John's wort; diabetic wounds; experimental; surgical wound; wound healing