A chronic wound is a wound that does not heal within a predictable period of time.
It may be a result of the interruption of the stage of wound healing or damage of the blood vessels that have a function in providing necessary conditions to promote the closure of the wound as seen in a diabetic leg ulcer.
In other words, any wound that does not heal with 3 months is considered a chronic wound.
According to the statistics provided by the study "An Economic Evaluation of the Impact, Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds", approximately, 2% of the population in developed countries suffer from chronic wounds.
Additionally, every year, more than 305 million cases of acute, traumatic and burn wounds are treated globally.
Believe it or not, chronic and acute wound affects more than nine times of people around the world compared to those living with cancer.
Some researchers suggested that pressure, trauma and/or lower extremity wounds, increased the bacterial load, interruption of the stage of wound healing including excessive proteases, degraded cell surface structures, and inappropriate treatment are considered the most potential causes of the conditions.
More precisely, if we can protect all stages of wound healing without interruption, the chronic wound can be preventable.
Bromelain, a proteolytic enzyme found in pineapples (Ananas comosus) has been used in traditional medicine as an inflammatory agent for the treatment of pains, strains, and muscle aches and pains and ease back pain and chronic joint pain, skin diseases, etc.
With an aim to find a natural compound for the treatment of the chronic wound, researchers examined the efficacy of bromelain-based enzymatic debridement of chronic wounds.
The study included 24 patients with chronic wounds of different aetiologies.
According to 2 consecutive single-arm studies assessing the enzymatic debridement efficacy in 2 medical centers, all wounds achieved an average of 68% ± 30% debridement in an average of 3.5 ± 2.8 enzymatic debridement 4-hour sessions.
17/24 patients showed the responding wounds (venous, diabetic, pressure, and post-traumatic aetiologies) of an average of 85% ± 12% debridement in 3.2 ± 2.5 applications, compared to 7/24 patients with no response.
There were no adverse effects reported by the patients. Based on the findings, researchers wrote, "These preliminary results indicate the potential safety and efficacy of bromelain-based enzymatic debridement in chronic wounds".
In vitro, according to the results of two soft tissue healing--fibroblasts and microvascular endothelial cells--were used as mono- and co-culture with bromelain, bromelain attenuated endothelial cell and fibroblast proliferation moderately.
The inhibition of cell proliferation was not associated with cell apoptosis but cell cycle arrest in the G0 phase.
In the comparable tested, bromelain did not reduce endothelial cell migration. whereas fibroblast migration was clearly slowed down.
In other words, bromelain displayed a significant decrease of myofibroblasts under both normoxic (from 19 to 12 %) and hypoxic conditions (from 22 to 15 %) coincident with higher levels of anti-inflammatory expression.
Based on the findings, researchers wrote, "Usage of bromelain as a therapeutic drug for chronic human wounds thus remains a very promising concept for the future".
Taken altogether, bromelain used alone or combined with other remedies may be considered supplements for the prevention and treatment of chronic wounds, pending to the confirmation of the larger sample size and multicenter human study.
Intake of bromelain in the form of supplement should be taken with extreme care to prevent overdose acute liver toxicity.
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Kyle J. Norton (Scholar, Master of Nutrition, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published online, including worldwide health, ezine articles, article base, health blogs, self-growth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bioscience, ISSN 0975-6299.
(1) Bromelain-based enzymatic debridement of chronic wounds: A preliminary report by Shoham Y1, Krieger Y1, Tamir E2, Silberstein E1, Bogdanov-Berezovsky A1, Haik J3, Rosenberg L. (PubMed)
(2) Bromelain down-regulates myofibroblast differentiation in an in vitro wound healing assay by Aichele K1, Bubel M, Deubel G, Pohlemann T, Oberringer M. (PubMed)
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