sildenafil-citrate and Burns

In burn wound healing, zones of burn, namely zone of hyperemia, the zone of stasis, and zone of coagulation, have crucial importance. These zones have been identified based on the pathophysiology of the burn, and treatment of burn has been improved. The zone of necrosis is treated by excision and repair through grafting. Zone of stasis fully recovers in 24-48 h if the burn treatment is managed well. Otherwise, it may convert to a zone of coagulation. Hyperemia zone is a zone that recovers itself. Recovery of the zone of stasis is very critical in burn treatment. Active oxygen radicals produced due to the hypermetabolism due to burn wounds are known to speed to the process of the zone of stasis converting into the zone of coagulation. The present experimental study aims to evaluate the effects of sildenafil and N-acetylcysteine on the zone of stasis and to establish whether they had any contribution to wound healing in burns.. In the present study, 32 four months old female Wistar Albino rats with 200±20 gr body weights were used. The rats were divided into four groups as the sham group (Group 1), the intraperitoneal group (Group 2), Sildenafil group (Group 3, intraperitoneal 10 mg/kg for 10 days), N-acetylcysteine (Group 4, intraperitoneal 100 mg/kg for 10 days). Tissue samples were collected for serum and cytopathology studies of the Malondialdehyde level, glutathione peroxidase, superoxide dismutase, and catalyze enzyme activity. All the rats were sacrificed on the 10th day of the tests edema, hyperemia, epithelial degeneration, necrosis, inflammatory infiltration and fibrosis measurements were made.. When compared with the controls, both of the treatment groups had lower tissue damage scores. MDA level was lower in Group 3 and 4 compared to Group 2 and lower in Group 3 compared to Group 4. SOD, catalase and GPH-Px levels were higher in Group 3 and Group 4 compared to Group 2 and higher in Group 3 compared to Group 4.. The results of our study conducted on an experimental burn model created by rats support that Sildenafil and N-acetylcysteine have positive effects, such as decreasing oxidative stress level and increasing wound healing in burns. Further experimental studies are required on this subject.

Topics: Acetylcysteine; Animals; Burns; Female; Oxidative Stress; Rats; Rats, Wistar; Sildenafil Citrate; Wound Healing

The Raynaud's phenomenon (RP) is characterized by an exaggerated vascular response to cold temperature or emotional stress causing temporary ischemia. It is more prevalent in the digits of the hands and feet, and when occurring in conjunction with a rheumatological condition, it is also termed Raynaud's syndrome, or secondary RP. Healing following a burn requires appropriate tissue perfusion to promote primary restoration of the skin, prevent further burn progression, and to promote skin graft take in wounds requiring autologous split skin grafting. The addition of vascular compromise caused by RP to a burn wound is therefore hypothesized to impair burn wound healing and worsen burn wound progression. The authors describe a 51-year-old female with digital burns on a background of scleroderma and Raynaud's syndrome successfully treated with oral sildenafil therapy and autologous split skin grafting. The case report further highlights the potential role for sildenafil therapy in wound healing and patients requiring autologous skin grafting or local skin flaps. In future cases, we plan to involve rheumatology services early in the course of the injury aiming to improve outcomes.

Topics: Burns; Combined Modality Therapy; Female; Hand Injuries; Humans; Middle Aged; Phosphodiesterase 5 Inhibitors; Raynaud Disease; Sildenafil Citrate; Skin Transplantation; Surgical Flaps

Severe burn induces systemic inflammation and reactive oxygen species leading to lipid peroxidation which may play role in remote organs injury. Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5. Sildenafil reduces oxidative stress and inflammation in distant organs. The aim of the present study was to evaluate the effects of different dosages of sildenafil in remote organs injury.. A total of thirty-two rats were randomly divided into four equal groups. The groups were designated as follows: Sham, Control, 10, and T20 mg/kg sildenafil treatment groups. Levels of malondialdehyde (MDA), vascular endothelial growth factor (VEGF), VEGF receptor (Flt-1), activities of glutathione peroxidase (Gpx), levels of total antioxidative capacity (TAC), and total oxidant status (TOS) were measured in both tissues and serum, and a semi-quantitative scoring system was used for the evaluation of histopathological findings.. Sildenafil increased levels of Gpx, and Flt-1, and decreased MDA and VEGF levels in tissues. Sildenafil also increased serum levels of TAC and Flt-1 and decreased TOS, OSI, and VEGF.. Sildenafil decreased inflammation scores in remote organs in histopathological evaluation. It has protective effects in severe burn-related remote organ injuries by decreasing oxidative stress and inflammation.

Topics: Animals; Burns; Female; Inflammation; Kidney; Lipid Peroxidation; Liver; Malondialdehyde; Models, Animal; Oxidative Stress; Random Allocation; Rats; Rats, Wistar; Sildenafil Citrate; Soft Tissue Injuries; Tumor Necrosis Factor-alpha; Vascular Endothelial Growth Factor A; Vasodilator Agents

Severe burn induces biochemical mediators such as reactive oxygen species that leads to lipid peroxidation which may have a key role in formation of acute lung injury (ALI). Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5. Sildenafil preserves alveolar growth, angiogenesis, reduces inflammation and airway reactivity. The purpose of the present study was to evaluate the effects of different dosages of sildenafil in ALI due to severe scald burn in rats. Twenty-four rats were subjected to 30% total body surface area severe scald injury and were randomly divided into three equal groups as follow: control, 10 and 20mg/kg sildenafil groups. Levels of malondialdehyde (MDA), activities of glutathione peroxidase (Gpx), catalase (Cat), total oxidative stress (TOS), and total antioxidative capacity (TAC) were measured in both tissues and serums. Oxidative stress index (OSI) was calculated. A semi-quantitative scoring system was used for the evaluation of histopatological findings. Sildenafil increased Gpx, Cat, TAC and decreased MDA, TOS and OSI. Sildenafil decreased inflammation scores in lungs. Our results reveal that sildenafil is protective against scald burn related ALI by decreasing oxidative stress and inflammation and the dosage of 10mg/kg could be apparently better than 20mg/kg.

Topics: Acute Lung Injury; Animals; Biomarkers; Burns; Catalase; Disease Models, Animal; Female; Glutathione Peroxidase; Malondialdehyde; Oxidative Stress; Phosphodiesterase 5 Inhibitors; Piperazines; Purines; Rats; Rats, Wistar; Sildenafil Citrate; Sulfones

Topics: Animals; Burns; Honey; Humans; Larva; Piperazines; Purines; Sildenafil Citrate; Sulfones; Vasodilator Agents; Wound Healing