title: The efficacy of probiotics as pharmacological treatment of cutaneous wounds: Meta-analysis of animal studies.
abstract: The aim of the current meta-analysis of animal studies was to evaluate the efficacy of probiotics as pharmacological treatment of cutaneous wounds. A systematic electronic literature search was conducted and in total six animal studies which undertake twelve experiments met our inclusion criteria. We used the percentage (%) of wound area at the end of the first week after initial wounding to evaluate the efficacy of the probiotic treatment. The heterogeneity was estimated as statistically significant (p<0.0001) and therefore the meta-analysis was performed with the random-effect model. Based on the estimated Hedges' g (Hedges, 1982), the administration of probiotics was associated with acceleration of the wound contraction (g=-2.55; 95%CI=-3.59, -1.50; p<0.0001). The meta-regression analysis showed that the moderator sterile kefir extract has the greater effect on the overall estimated efficacy of probiotic treatment (g=-5.6983; p=0.0442) with bacteria probiotic therapies (70% kefir gel, L. brevis, L. fermentum, L. plantarum, L. reuteri) following (g=-2.3814; p=0.0003). For bacteria dose moderator, the results showed that increase in bacterial dose corresponds to increase of the estimated overall effect size (g=-10.2056; p=0.0053). The linear regression test of funnel plot asymmetry showed absence of publication bias. In conclusion, the results indicate that probiotics administration is an effective pharmacological treatment of cutaneous wounds. However, due to the heterogeneity among studies, further research is required.
authors.affiliation: Department of Nursing, Faculty of Health and Caring Professions, Technological Educational Institution of Athens, Greece.
authors.forename: Christos G
authors.initials: CG
authors.lastname: Tsiouris
authors.affiliation: Department of Nursing, Faculty of Health and Caring Professions, Technological Educational Institution of Athens, Greece.
authors.forename: Martha
authors.initials: M
authors.lastname: Kelesi
authors.affiliation: Department of Nursing, Faculty of Health and Caring Professions, Technological Educational Institution of Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Vasilopoulos
authors.affiliation: Department of Nursing, Faculty of Health and Caring Professions, Technological Educational Institution of Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kalemikerakis
authors.affiliation: Department of Medical Laboratories, Faculty of Health and Caring Professions, Technological Educational Institution of Athens, Greece. Electronic address: efipapag@teiath.gr.
authors.forename: Effie G
authors.initials: EG
authors.lastname: Papageorgiou
mesh_terms: D000818:Animals; D019936:Probiotics / Q000627:therapeutic use*; D012867:Skin / Q000293:injuries; D014945:Wound Healing / Q000187:drug effects*
keywords: Cutaneous wound; Kefir; Lactobacillus; Meta-analysis; Probiotics; Wound healing