Investigation of activity dressing made with bitter melon extract by dressings made BY using pure olive oil, nitrofurazone and normal saline in ischemic wound healing

Momordica is one of the medicinal plants. One of the known effects of momordica is wound healing. The plant has been reported to precipitate growth factor production, stimulate fibroblast proliferation, increase oxygenation, to be an important factor in wound healing through accelerating capillary circulation. Many phyto-chemicals such as flavonoid and glycoside found in its composition have been reported to accelerate wound healing through anti-oxidant and anti-microbial activities and lead to positive outcomes with regard to wound contraction ability, wound closure time, epithelization process, tensile strength of the wound and the wound healing rate. The ripe fruits of momordica are used for treatment of wounds. This is a randomized controlled study aiming at investigating the effects of the plant on particularly ischemic chronic wounds, as it is widely used for wound healing and the application is easy and painless. The research was conducted at Afyon Kocatepe University Experimental Animals Research and Training Center between 15.10.2014 and 01.04.2014. The study universe was composed of male rats aged 6-8 weeks (1.5-2 months) weighing 200-250 gr. Two 2x2 cm full-thickness square wounds were created, one in the cephalic and one in the caudal region in the ischemic wound model formed with bi-pedicled flap on the dorsum of each rat that had fulfilled the inclusion criteria. In the study model composed of one control and three test groups, the wounds on the dorsum of the rats in the momordica group were dressed with the momordica extract with olive oil; the wounds in the pure olive oil group were dressed with pure olive oil, and the rats in nitrofurantoin group were dressed with nitrofurazone ointment for 21 days. The wounds were evaluated on days 7, 14 and 21 with regard to wound area, percentage of wound healing and macroscopic re-epithelization. The rats were sacrificed on day 21 and wound samples were obtained for histological examination. The wounds were histologically examined with regard to epithelization, collagen, fibroblast, inflammatory cells, and revascularization criteria. The results showed that there was no statistically significant difference between the groups with regard to cephalic wound area averages (p>0.05), and that there was a statistically significant difference between the groups with regard to caudal wound area averages (p<0.05), and that the changes between days 7 and 21 were statistically significant in the in-group assessments of both cephalic and caudal wounds (p<0.05). There was no statistically significant difference between the cephalic wound healing percentages (p>0.05); there was a statistically significant difference between the caudal wound healing percentages (p<0.05). There was a statistically significant difference between the groups with regard to wound healing area percentages. The decrease at the wound area was less for both the cephalic and the caudal wounds in the nitrofurazone group and wound healing took a longer time in this group. The number of wounds which were totally closed and healed on day 21 was seen to be highest in the momordica group, in both the cephalic and caudal wounds, and epithelization, collagen, fibroblast, and the revascularization scores were higher in the momordica group compared to the other groups. The outcomes of the pure olive oil group were close to the momordica group. The momordica group had the lowest inflammatory cell scores. Our results showed that administration of topical momordica extract led to significant developments in wound healing and that it could be used as an alternative treatment approach.