Histopathological and mechanical effects of Ankaferd Blood Stopper® on wound healing in rats: an experimental model
Histopathological and mechanical effects of Ankaferd Blood Stopper® on wound healing in rats: an experimental model
Background/aim: To evaluate the histopathological and mechanical effects of Ankaferd Blood Stopper (ABS) application on wound healing. Materials and methods: A total of 24 Wistar albino rats were randomly divided into three equal groups. In each group, a 3 cm-long midline vertical skin incision was performed in the back of the rats. In Group 1, the incision was sutured primarily. In Group 2, incision was left to secondary healing. In Group 3, ABS was applied to the incision. On the 10th day, burst pressure width was measured, and rats were sacrificed. The tissue samples were examined histopathologically. Statistical analysis was conducted with IBM SPSS program. P < 0.05 was considered significant. Results: The mean burst pressure widths of wound separation were 13.66 ± 0.457, 7.18 ± 2.599, and 13.66 ± 1.11 mm for Groups 1–3, respectively. The difference in burst pressure width between Groups 1 and 3 was not significant (P > 0.05) but was significant between Groups 2 and 3 (P = 0.000). The vascular proliferation median values were 1, 2, and 2, for Groups 1–3, respectively. Although the difference was significant between Groups 1 and 2 in terms of vascular proliferation score (P = 0.047), no significant difference was observed between Group 3 and others. No statistically significant difference was observed among the groups in terms of collagen score, mononuclear cell infiltration, and polymorphonuclear cell proliferation (P > 0.05). The median values of fibroblast proliferation score were 1, 2, and 3, in Groups 1–3, respectively. Fibroblast proliferation score significantly differed between Groups 1 and 3 (P = 0.003). Conclusion: ABS application results in a clean wound healing that is as strong as primary repair. However, additional studies are required to evaluate the late results of increased fibroblastic activity in the early period of ABS application alone.
___
- 1. Brissett AE, Hom DB. The effects of tissue sealants, platelet gels, and growth factors on wound healing. Current Opinion in Otolaryngology & Head and Neck Surgery 2003; 11 (4): 245- 250. doi: 10.1097/00020840-200308000-00005
- 2. Oryan A, Mohammadalipour A, Moshiri A, Tabandeh MR. Topical application of aloe vera accelerated wound healing, modeling, and remodeling: an experimental study. Annals of Plastic Surgery 2016; 77 (1): 37-46. doi: 10.1097/ SAP.0000000000000239
- 3. Zekavat O, Amanat A, Karami M, Paydar S, Gramizadeh B et al. Wound healing studies using punica granatum peel: an animal experimental study. Advances in Skin & Wound Care 2016; 29 (5): 217-225. doi: 10.1097/01.ASW.0000481116.16998.55
- 4. Cieslik-Bielecka A, Pierchala M, Krolikowska A, Reichert P. Effect of L-PRP treatment on wound healing after surgical skin incision in an experimental animal model. Connective Tissue Research 2018; 59 (6): 550-560. doi: 10.1080/03008207.2018.1424148
- 5. Gul M, Gunay A, Tanik A. An evaluation of the effects of caffeic acid phenethyl ester and Ankaferd blood stopper on secondary wound healing of oral mucosal tissue. Turkish Journal of Medical Sciences 2020; 50 (1): 248-257. doi: 10.3906/sag-1908- 114
- 6. Kovac I, Durkac J, Holly M, Jakubcova K, Perzelova V et al. Plantago lanceolata L. water extract induces transition of fibroblasts into myofibroblasts and increases tensile strength of healing skin wounds. The Journal of Pharmacy and Pharmacology 2015; 67 (1): 117-125. doi: 10.1111/jphp.12316
- 7. Akalin C, Kuru S, Barlas AM, Kismet K, Kaptanoglu B et al. Beneficial effects of Ankaferd Blood Stopper on dermal wound healing: an experimental study. International Wound Journal 2014; 11 (1): 64-68. doi: 10.1111/j.1742-481X.2012.01063.x
- 8. Garber A, Jang S. Novel therapeutic strategies in the management of non-variceal upper gastrointestinal bleeding. Clinical Endoscopy 2016; 49 (5): 421-424. doi: 10.5946/ ce.2016.110
- 9. Ezirganli S, Kazancioglu HO, Acar AH, Ozdemir H, Kuzu E et al. Effects of Ankaferd BloodStopper on bone healing in an ovariectomized osteoporotic rat model. Experimental and Therapeutic Medicine 2017; 13 (5): 1827-1831. doi: 10.3892/ etm.2017.4166
- 10. Yuce S, Candirli C, Yenidunya S, Muslu B. New hemostatic agent: the effect of Ankaferd Blood Stopper on healing wounds in experimental skin incision model. Turkish Journal of Medical Sciences 2014; 44 (2): 288-294. doi: 10.3906/sag-1302- 92
- 11. Ciftciler R, Koluman A, Haznedaroglu IC, Akar N. Effects of Ankaferd Hemostat on Helicobacter pylori strains and antibiotic resistance. Turkish Journal of Medical Sciences 2019; 49 (1): 347-355. doi: 10.3906/sag-1807-206
- 12. Boran R, Baygar T, Sarac N, Ugur A. Ankaferd Blood Stopper with antibiofilm potential successfully inhibits the extracellular matrix degradation enzymes and promotes wound healing of 3T3 fibroblasts in vitro. Turkish Journal of Medical Sciences 2018; 48 (3): 627-634. doi: 10.3906/sag-1712-80
- 13. Sonmez M, Baltacioglu E, Sarac O, Erkut N. The use of Ankaferd blood stopper in a patient with Glanzmann’s thrombasthenia with gingival bleeding. Blood Coagulation & Fibrinolysis 2010; 21 (4): 382-383. doi: 10.1097/MBC.0b013e328335f1b8
- 14. Kazancioglu HO, Cakir O, Ak G, Zulfikar B. The effectiveness of a new hemostatic agent (Ankaferd Blood Stopper) for the control of bleeding following tooth extraction in hemophilia: a controlled clinical trial. Turkish Journal of Haematology 2013; 30 (1): 19-24. doi: 10.4274/tjh.2012.0036
- 15. Nehete MN, Nipanikar S, Kanjilal AS, Kanjilal S, Tatke PA. Comparative efficacy of two polyherbal creams with framycetin sulfate on diabetic wound model in rats. Journal of Ayurveda and Integrative Medicine 2016; 7 (2): 83-87. doi: 10.1016/j. jaim.2015.09.004
- 16. Aarabi S, Bhatt KA, Shi Y, Paterno J, Chang EI et al. Mechanical load initiates hypertrophic scar formation through decreased cellular apoptosis. FASEB Journal 2007; 21 (12): 3250-3261. doi: 10.1096/fj.07-8218com
- 17. Kalin M, Kuru S, Kismet K, Barlas AM, Akgun YA et al. The effectiveness of porcine dermal collagen (Permacol®) on wound healing in the rat model. The Indian Journal of Surgery 2015; 77 (Suppl 2): 407-411. doi: 10.1007/s12262-013-0854-z
- 18. Werner S, Grose R. Regulation of wound healing by growth factors and cytokines. Physiological Reviews 2003; 83 (3): 835- 870. doi: 10.1152/physrev.2003.83.3.835
- 19. Li J, Chen J, Kirsner R. Pathophysiology of acute wound healing. Clinics in Dermatology 2007; 25 (1): 9-18. doi: 10.1016/j.clindermatol.2006.09.007
- 20. Bainbridge P. Wound healing and the role of fibroblasts. Journal of Wound Care 2013; 22 (8): 407-408, 10-12. doi: 10.12968/ jowc.2013.22.8.407
- 21. Ay S, Unlu Y. Comparison of Ankaferd Blood Stopper and silver sulfadiazine use in burn wounds: An experimental study. Turkish Journal of Trauma & Emergency Surgery 2019; 25 (4): 338-342. doi: 10.14744/tjtes.2019.38265
- 22. Dincol ME, Ozbas H, Yilmaz B, Ersev H, Gokyay S et al. Effect of the plant-based hemostatic agent Ankaferd Blood Stopper ® on the biocompatibility of mineral trioxide aggregate. BMC Oral Health 2016; 16 (1): 111. doi: 10.1186/s12903-016-0302-0
- 23. Goker H, Haznedaroglu IC, Ercetin S, Kirazli S, Akman U et al. Haemostatic actions of the folkloric medicinal plant extract Ankaferd Blood Stopper. The Journal of International Medical Research 2008; 36 (1): 163-170. doi: 10.1177/147323000803600121
- 24. Turk S, Malkan UY, Ghasemi M, Hocaoglu H, Mutlu D et al. Growth inhibitory activity of Ankaferd hemostat on primary melanoma cells and cell lines. SAGE Open Medicine 2017; 5: 2050312116689519. doi: 10.1177/2050312116689519
- 25. Ugur A, Sarac N, Cankal DA, Ozle M. The antioxidant and antimutagenic activities of Ankaferd blood stopper,a natural hemostatic agent used in dentistry. Turkish Journal of Medical Sciences 2016; 46 (3): 657-663. doi: 10.3906/sag-1504-62
- 26. Ciftciler R, Aksu S, Dikmenoglu Falkmarken N, Haznedaroglu IC. Effects of Ankaferd Hemostat on red blood cell aggregation: a hemorheological study. Turkish Journal of Medical Sciences 2019; 49 (1): 356-360. doi: 10.3906/sag-1808-60
- 27. Devran F, Bicakci U, Tosun M, Tander B, Aydin BK et al. Ankaferd Blood Stopper®: Is the source of intraperitoneal adhesion? Gineco Ro 2010; 6: 183-185.
- 28. Buyuktiryaki M, Tayman C, Koyuncu I, Cakir U, Taskin Turkmenoglu T et al. Therapeutic and preventative effects of ankaferd blood stopper in an experimental necrotizing enterocolitis model. Biomedicine & Pharmacotherapy 2019; 110: 105-110. doi: 10.1016/j.biopha.2018.11.023
- 29. Beyazit F, Buyuk B. An immunohistochemistry and histopathological study of ankaferd blood stopper in a rat model of cervical inflammation. Revista da Associacao Medica Brasileira (1992). 2019; 65 (2): 183-190. doi: 10.1590/1806- 9282.65.2.183
- 30. Servet E, Bekler H, Kilincoglu V, Ozler T, Ozkut A. Effect of bleeding on nerve regeneration and epineural scar formation in rat sciatic nerves: an experimental study. Acta Orthopaedica et Traumatologica Turcica 2016; 50 (2): 234-241. doi: 10.3944/ AOTT.2015.15.0090
- 31. Aydin BK, Altan E, Acar MA, Erkocak OF, Ugras S. Effect of Ankaferd blood stopper® on tendon healing: an experimental study in a rat model of Achilles tendon injury. Eklem Hastalik Cerrahisi 2015; 26 (1): 31-37. doi: 10.5606/ehc.2015.08
- 32. Sheela ML, Ramakrishna MK, Salimath BP. Angiogenic and proliferative effects of the cytokine VEGF in Ehrlich ascites tumor cells is inhibited by Glycyrrhiza glabra. International Immunopharmacology 2006; 6 (3): 494-498. doi: 10.1016/j. intimp.2005.07.002
- 33. Cancan G, Teksoz S, Aytac E, Arikan AE, Erman H et al. Effects of Ankaferd on anastomotic healing of colon. Journal of investigative surgery 2014; 27 (1): 1-6. doi: 10.3109/08941939.2013.826308
- 34. Verhofstad MH, Lange WP, van der Laak JA, Verhofstad AA, Hendriks T. Microscopic analysis of anastomotic healing in the intestine of normal and diabetic rats. Diseases of the Colon and Rectum 2001; 44 (3): 423-431. doi: 10.1007/BF02234744
- 35. Sakar A, Bilecik T, Mayir B, Oruc T. The potential effects of Ankaferd blood stopper and fibrin sealent on sleeve gastrectomy staple-line healing: An experimental study. Experimental and Therapeutic Medicine 2019; 18 (4): 2519-2523. doi: 10.3892/ etm.2019.7842
- 36. Kamus L, Theoret C. Choosing the Best Approach to Wound Management and Closure. The Veterinary Clinics of North America. Equine Practice 2018; 34 (3): 499-509. doi: 10.1016/j. cveq.2018.07.005