Deneysel temas tipi yanıklarda acil uygulanan tedavi yöntemlerinin yara iyileşmesi üzerine etkilerinin Momordica charantia (kudret narı) topikal tedavisi ile karşılaştırılması
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Dosyalar
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Yanık yaralarında çeşitli topikal ajanlar kullanlılmaktadır.Gümüş sülfadiazin (GSD) uygulama kolaylığı ve göreceli olarak toksisitesinin az olmasından dolayı dünyada en fazla tercih edilen topikal ajandır.[1-3]. Ancak tedavide etkin ve ortak bir yöntem olarak belirlenmiş bir ajan veya uygulama yöntemi görülmemektedir. Momordica Charantia (kudret narı), halk arasında pek çok rahatsızlığın tedavisinde uzun yıllardır kullanılmaktadır [4-10]. Yanık tedavisinde de etkili olabileceğini düşündürecek pek çok özelliği mevcuttur . Yapılan literatür taramasında yanık hastalarında veya deneysel yanık modellerinde Momordica Charantia etkileri üzerine klinik ve deneysel çalışmaların az olduğu dikkat çekmektedir. Acil uygulanan tedavi yöntemlerinden olan yanığa topikal gümüş sülfadiazin (GSD) uygulamasını, topikal Momordica Charantia tedavisi ile kıyaslayan bir çalışmaya da rastlamadık. Bu nedenle uzun zamandır yanık ve yara iyileşmesi üzerine etkili olduğu düşünülen Momordica Charantia'nın deneysel temas tipi yanıklarda yara iyileşmesi üzerine etkili olup olmadığının belirlenmesi ve etkilerinin acil uygulanan tedavi yöntemlerinden topikal GSD uygulaması ile karşılaştırılması amaçlandı. YÖNTEM: Çalışmada Ege Üniversitesi, Tıp Fakültesi, Deney Hayvanları Yetiştirme Merkezi'nden temin edilen, seksüel olgunluğa erişmiş, ağırlıkları 200-220 gram arasında değişen, sadece dişi eşeyden, 35 adet sağlıklı Spruge Dawley cinsi sıçan kullanıldı. Sıçanlar beş gruba ayrıldı. İntraperitoneal ksilazin ve ketamin anestezisi sonrası bütün deneklerin sol torakodorsalinde iki, sağ torakodorsalinde bir olmak üzere toplamda üç adet, aralarında sağlam cilt dokusu bırakacak şekilde 1x1 cm'lik kare alanlar traşlanarak kıllardan arındırıldı. Yanık modeli oluşturmak amacıyla tasarlanan cihazın sabit 100°C sıcaklıkta tutulan, 1x1 cm'lik kare şeklindeki bakır ucu traşlanan alanlara 10 saniye boyunca ekstra basınç uygulanmadan temas ettirilerek yanık oluşturuldu. Daha sonra gruplarda planlanan işlemler her bir gruba ayrı ayrı sırası ile gerçekleştirildi. Grup I'e (kontrol grubu) herhangi bir işlem veya tedavi uygulanmadı. Grup II'ye (yanık kontrol grubu) yanık uygulaması sonrası sadece 100 cc serum fizyolojik (SF) ile iki dakika irrigasyon sağlanıp ilaçsız pansuman ile kapatıldı. Grup III'e (GSD grubu) yanık oluşturulması sonrası topikal GSD tedavisi altı saat ara ile toplamda dört kez (0, 6, 12 ve 18. saatlerde) uygulandı. Grup IV'e (kudret narı grubu) yanık oluşturulması sonrası momordica charantia 'dan yapılan jel altı saat ara ile toplamda dört kez uygulandı. Grup V'e (jel grubu) ise yanıktan sonra altı saat ara ile toplamda dört kez plasebo jel uygulandı. Sıçanlarda yanık oluşturulan üç bölgeden 4, 8 ve 24. saatlerde tam kat deri biyopsileri alınarak ışık mikroskobu altında, hematoksilen eozin (H&E) boyama ile histolojik olarak incelendi. Elde edilen veriler SPSS (Statistical Package For Social Sciences) 15.0 programında oluşturulan veri tabanına girildi ve istatistiksel analizler aynı program ile yapıldı. BULGULAR: Ödem miktarının değerlendirilmesinde grupların birbirleri arasında yapılan karşılaştırmalar sonucunda; kudret narı-gümüş sülfadiazin ve kudret narı-jel grubu ile karşılaştırmalarında 4. saatte anlamlı fark (p<0.05) saptanırken, 8. ve 24. saatte istatistiksel olarak anlamlı fark (p>0.05) gözlenmedi. Kontrol grubunun tüm gruplarla karşılaştırmalarında istatistiksel olarak anlamlı fark (p<0.05) ödem miktarı açısından saptanırken, yalnızca kudret narı ile 24. saatte anlamlı fark (p>0.05) oluşmadığı saptandı. Gümüş sülfadiazin-jel karşılaştırmasında da 8.ve 24. saatte istatistiksel olarak anlamlı fark saptanmamıştır (p<0.05). PMNL infiltrasyonu açısından bakıldığında kudret narı grubu dışındaki diğer tüm gruplarda PMNL infiltrasyounun ilk 8 saat içerisinde artarak devam ettiği gözlemlendi. yine kudret narı dışındaki gruplarda enyüksek PMNL değeri 8. saatte izlenirken, kudret narı grubunda en yoğun PMNL hakimiyeti 4. ve 8. satte görüldü ve 24. saatte istatistiksel olarak anlamlı azalma görüldü. Grupların birbirleriyle karşılaştırılmasında; gümüş sulfadiazine-jel, kudret narı-gümüş sülfadiazin, kudret narı-jel karşılaştırımalarında istatistiksel olarak anlamlı fark bulunmamıştır (p>0.05). Kollojen diskolarizasyonu yanık kontrol ve jel grubunda 4. saatte en yüksek değerlerdeyken 8. saatte azalarak en düşük değerine 24. saatte ulaştı. Gümüş sülfadiazin grubunda 4. ve 8. saatte anlamlı değişiklik yokken 24. saatte bir miktar azalma gözlemlendi. Kudret narı grubunda ise diğer 3 gruba kıyasla diskolarizasyondaki azalma 4. saatte belirgindi; 8. ve 24 saatlerde ise diskolarizasyon azalmasında progresyon gözlendi. Grupların kendi arasında karşılaştırılmasında; gümüş sülfadiazin-kudret narı, gümüş sülfadiazin-jel ve kudret narı-jel gruplarının 4. ve 8. saatlerinde anlamlı değerler elde edilirken (p<0.05), 24. saatte istatistiksel olarak anlamlı değer elde edilemedi (p>0.05). Damar hasarı kudret narı grubunda en fazla 4. saatte gözlenirken, 8, ve 24. saatte progresif azalma gözlemlendi. Gümüş sülfadiazin grubunda en yüksek değerler 8. saatte, en düşük değerler ise 24. saatte gözlemlendi. Yapılan ikili karşılaştırmalarda istatistiksel olarak gümüş sülfadiazin-kudret narı arasında anlamlı fark elde edildi (p<0.05). Kıl kökü hasarı ile ilgili tüm gruplarda en yüksek değerler 4. saatte gözlemlenirken 8. ve 24. saatte kıl kökü hasarının azaldığı görüldü. Ayrıca kudret narı grubunda iyileşmenin diğer gruplara kıyasla daha hızlı ve iyi olduğu görüldü. Gümüş sülfadiazin-kudret narı karşılaştırmasında 8. ve 24. saatte anlamlı değerler (p<0.05) bulunurken 4. saatte istatistiksel olarak anlamlı değer elde edilemedi (p>0.05). Glandula sebasea hasarı değerlendirmesinde kontrol grubu dışındaki grupların birbirleri arasında yapılan karşılaştırmalar sonucunda sadece kudret narı'nın glandula sebasea hasarını azaltıcı ve iyileştirici etkisi olduğu göze çarpmaktadır. Epidermis kalınlığı ikili karşılaştırmalar sonrası 4. , 8. ve 24. saatlerde; kudret narı-yanık ve jel-yanık değerleri anlamlı fark göstermiştir (p<0.05). Gümüş sülfadiazin-kudret narı karşılaştırılması sonrası 4., 8. ve 24. saatlerde kudret narı yönünde anlamlı fark (p<0.05) göstermiştir. Jel-kudret narı karşılaştırması sonrası 4. ,8. ve 24. saatlerde anlamlı farklılık göstermiştir (p<0.05). Jel-gümüş sülfadiazin karşılaştırması sonrası 24. saatte anlamlı farklılık gösterirken (p<0.05), 4. ve 8. saatlerde anlamlı farklılık göstermemiştir (p>0.05). Epidermis kalınlığı grupların kendi süreçleri içinde değerlendirildiğinde yanık, gümüş sülfadiazin, kudret narı ve jel grubunda anlamlı farklılık göstermiştir (p<0.05).
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.
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.
Açıklama
Anahtar Kelimeler
Momordica Charantia, Yanık, Kudret Narı, Tedavi, Gümüş Sülfadiazin, Topical Momordica Charantia, Burns, Wound Healing, Bitter Melon, Silver Sülfadiazin
