Comparison of the topical momordica charantia (bitter melon)treatment and the effects of emergency treatment methods on the wound healing in experimental contact burns

PURPOSE: There are several topical agents in use at burn treatment. Silver sulfadiazin is the mostly used topical agent because of it's less toxicity and simplicity of use. Therefore, there are not any effective treatment or common application method. Momordica Charantia, has been used for years to treat many ailments among the people. This plant possesses many properties that cause to think that it can be effective in burn treatment. In the literature, it is conspicuous that clinical and experimental studies have been too few and insufficient about the effects of Momordica Charantia in patients with burns and experimental burn models. Additionally, we saw that there has not been any collaborative study about comparison of topical Momordica Charantia application and topical silver sulfadiazine (SSD) treatment, which is one of the emergency treatment methods in burn wounds. Therefore, it was aimed to determine whether Momordica Charantia, which has been regarded to be effective on burn and wound healing, is effective on experimental contatct burns in terms of wound healing, or not and compare its effects with SSD that is one of the emergency treatment methods. METHOD: 35 healthy Spruge Dawley rats, which were obtained from Experimental Animal Breeding Center of Ege University Faculty of Medicine, and wew of sexual maturity, of weight 200-220 gr, of female sex, were subjected to the study. Rats were seperated into 5 groups. After intraperitoneal xyzaline and ketamine anaesthesia, areas of 1x1 cm were cleaned of hair by shaving in a manner that leaved total three areas being one area on left thoracodorsal and two areas on right thoracodorsal of all subjects, and solid skin texture between those areas. Burns were formed by contacting the 1x1 cm copper end, which was kept at 100 C constant temperature, of the device designed with the aim of forming burn model of the shaved areas for 10 seconds without appyling extra pressure. Then, the procedures planned were performed respectively for each group. Any procedure or treatment was not applied to Group I. In Group II, burns were only irrigated with 100 cc normal salin for two minutes and covered only with drug-free dressing after burn application. In Gruoup III, the topical SSD was applied for four times with six hour intervals ( at the hours 0, 6, 12 and 18). In Group IV, the gel prepared from Momordica Charantia was applied four times with the six hour intervals after burn application. In Group V, plain gel was applied for four times with six-hour intervals after burn application. Full-thickness skin biopsies, which are taken from three burned areas of the rats at the hours 4, 8 and 24 were examined under a light microscope with hematoxylin and eosin (H&E) staining. The data from this was entered to SPSS( Statistical Package For Social Sciences) 15.0 database and statistical analyzes were applied with the same program. FINDINGS: In evaluating the amount of edema, as a result of the comparison between the groups, while a meaningful difference (p<0.05) was detected in the 4th hour between the momordica charantia-silver sulfadiazine and momordica charantia-jelly groups, no meaningful difference (p>0.05) was observed statistically during the in 8th and 24th hours. In comparing the control group with all other groups, a statistically meaningful difference (p<0.05) was ascertained in terms of the amount of edema, the meaningful difference (p>0.05) was not detected only with momordica charantia in the 24th hour. The said difference was not detected while comparing the silver sulfadiazine-jelly either. In terms of PMNL infiltration, in all groups except the momordica charantia, a gradual increase of PMNL infiltration was detected within the first 8 hours. Similarly, in all groups except the momordica charantia, the highest PMNL infiltration was observed in the 8th hour, with the momordica charantia group, the most intensive PMNL value was observed in the 4th and 8th hours and there was a statistically meaningful decrease in the 24th hour. In comparing the groups amongst themselves, silver sulfadiazine-jelly, momordica charantia-silver sulfadiazine and momordica charantia-jelly, no statistically meaningful difference (p>0.05) was found. Collagen discoloration burnt in control and jelly group was at its highest level in the 4th hour, while it began to decrease in the 8th hour and reached its lowest level in the 24th hour. In silver-sulfadiazine group, there was no meaningful difference in the 4th and 8th hours, while a certain amount of decrease was observed in the 24th hour. In the momordica charantia group, the amount of decrease in discoloration in the 4th hour was distinct, compared with other three groups and in the 8th and 24th hours, a progression was observed in the amount of decrease of discoloration. In comparing the groups among themselves, meaningful values (p<0.05) were obtained in the 4th and 8 hours in silver sulfadiazine-momordica charantia, silver sulfadiazine-jelly and momordica charantia-jelly groups, while in the 24th hour, no statistically meaningful value (p>0.05) was obtained. Vein damage was detected mostly in the 4th hour in momordica charantia group, and progressive decrease was observed in the 8th and 24th hours. In silver-sulfadiazine group, the highest values were observed in the 8th and the lowest values were observed in the 24th hour. A statistically meaningful difference (p<0.05) was obtained during the comparison between silver sulfadiazine and momordica charantia. The highest hair follicle damage values were observed in the 4th hour, whereas in the 8th and 24th hours, a decrease was observed in the said values. It was observed that the healing was faster and better in momordica charantia group compared to other groups. Meaningful values (p<0.05) were observed in the 8th and 24th hours in comparing the silver-sulfadiazine- momordica charantia groups, while no statistically meaningful value (p>0.05) was obtained in the 4th hour. In evaluating sebaceous glands damage, as a result of the comparison between the groups except the control group, it is remarkable that only momordica charantia group has a healing and ameliorating effect sebaceous glands damage. Epidermis thickness displayed meaningful difference in momordica charantia-burnt and jelly-burnt values in 4th, 8th and 24th hours (p<0.05). Asa a result of the comparison between silver sulfadiazine and momordica charantia, it has shown meaningful difference (p<0.05) in 4th, 8th and 24th hours towards momordica charantia. In comparing the jelly- momordica charantia, it has shown a meaningful difference (p<0.05) in the 4th, 8th and 24th hours. In comparing the jelly-silver sulfadiazine, while it has shown a meaningful difference (p<0.05) in the 24th hour, it has not shown a meaningful difference (p>0.05) in the 4th and 8th hours. If the epidermis thickness is assessed within the processes of the groups themselves, the burnt has shown a meaningful difference (p<0.05) in silver-sulfadiazine, momordica charantia and jelly groups. As a result of the dual comparisons, the group which was being treated by momordica charantia showed a meaningful difference (p<0.05) than all other groups in terms of the number of degenerated hair follicle in the 4th, 8th and 24th hours. It did not show a meaningful difference (p>0.05) in comparing the silver sulfadiazine-jelly groups. It showed a meaningful difference (p<0.05) in silver sulfadiazine-burnt comparison in the 8th hour, however it showed no meaningful difference (p>0.05) in the 4th and 24th hours. When compared within their groups in terms of degenerated hair follicle numbers, momordica charantia showed a meaningful difference (p<0.05), while no meaningful value (p>0.05) was obtained in the other groups. Dual comparisons concerning vein numbers showed meaningful differences in the 4th, 8th and 24th hours, while control and burnt groups showed meaningful differences in all comparisons in the 4th, 8th and 24th hours (p<0.05). While momordica charantia-silver sulfadiazine showed no meaningful difference (p>0.05) in the 8th hour, momordica charantia showed a meaningful difference compared to all other groups. Silver sulfadiazine-jelly comparison showed a meaningful difference in the 4th, 8th and 24th hours. The vein numbers were evaluated within their processes and showed no meaningful difference for all groups (p>0.05). Total number of hair follicle comparisons in the 4th, 8th and 24th hours and the comparison of burnt-silver sulfadiazine and jelly-silver sulfadiazine groups showed no meaningful difference (p>0.05). Amongst momordica charantia-silver sulfadiazine, momordica charantia-burnt and momordica charantia-jelly it showed a meaningful difference (p<0.05) in the 8th hour, while it showed no meaningful difference (p>0.05) in the 4th and 24th hours. Total number of hair follicle groups within their internal processes, showed a meaningful difference for those groups having a momordica charantia treatment, while it showed no meaningful difference (p>0.05) for the other groups. RESULT: In this thesis study, it was observed that the topical Momordica Charantia treatment that was applied in acute experimental contact burns, reduce the PMNL infiltration, collagen discoloration, damages of glandula sebecea, number of the degenerate hair follicle. Momordica Charantia also was effective both for the protection of the number of vessels and epidermal thickness. It was seen that topical SSD treatment had statistically significant effects for only reducing the collagen discoloration and both protection of the number of the vessels and epidermal thickness.