Enhanced electroscalpel incisional wound healing potential of honey in wistar rats

Peer review under responsibility of Faculty of Veterinary Medicine, Cairo University.

Figures & data

Table 1 Evaluation of wound exudation, edge edema and hyperemia in electro-scalpel and cold scalpel induced wounds in rats.

Day	Electroscalpel									Cold Scalpel
	SILVER SULPHADIAZINE			Control			Honey			SILVER SULPHADIAZINE			Control			Honey
	WE	WEE	WH	WE	WEE	WH	WE	WEE	WH	WE	WEE	WH	WE	WEE	WH	WE	WEE	WH
1	0	6(100%)	6(100%)	0	6(100%)	6(100%)	0	6(100%)	6(100%)	6(100%)	6(100%)	6(100%)	6(100%)	6(100%)	6(100%)	6(100%)	6(100%)	6(100%)
2	0	6(100%)	6(100%)	0	6(100%)	6(100%)	0	6(100%)	6(100%)	3(50%)	5(83%)	5(66%)	4(66%)	4(66%)	6(100%)	3(50%)	4(66%)	6(100%)
3	0	5(83%)	6(100%)	0	5(83%)	6(100%)	0	2(33%)	6(100%)	3(50%)	3(50%)	5(83%)	4(66%)	3(50%)	5(83%)	3(50%)	3(50%)	4(66%)
4	0	3(50%	3(50%)	0	5(83%)	3(50%)	0	2(33%)	3(50%)	2(33%)	2(33%)	2(33%)	2(33%)	3(50%)	2(33%)	2(33%)	2(33%)	1(16%)
5	0	3(16%)	1(16%)	1(16%)	4(66%)	1(16%)	0	2(33%)	1(16%)	0	0	0	0	0	1(16%)	0	0	0
6	1(16)*	3(50%)	0	0	4(66%)	0	0	2(33%)	0	0	0	0	0	0	0	0	0	0
7	1(16)*	0	0	0	0	0	0	0	0	0	0	0	1(16%)	0	0	0	0	0
8	1(16)*	0	0	1(16%)	0	0	0	0	0	0	0	0	0	0	0	0	0	0
9	1(16)*	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
10>	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0

WE – wound exudation; WEE – wound edge edema; WH – wound hyperemia.

Fig. 1 Gross examination of wounds: A – wounds created with electroscalpel at day 5 still having exudation and thick granulation tissue. B – Wounds created with cold scalpel at days 5 already healing progress and contraction of wound surface. C – Wounds created with electroscalpel at day 14 showing wound surface contraction. D – Wounds created with cold scalpel at days 14 already contracted. (S = silver sulphadiazine, C = control, H = honey).

Table 2 Mean daily percentage wound contraction in electroscalpel and cold scalpel induced wounds in rats.

Day	Electro-scalpel			Cold Scalpel
	SSD	Control	Honey	SSD	Control	Honey
1.	6.75 ± 0.86^a	4.99 ± 2.64^a	7.26 ± 1.48^a	16.87 ± 7.39^a	7.60 ± 3.21^a	9.76 ± 3.95^a
2.	10.21 ± 4.31^a	7.91 ± 2.24^a	9.01 ± 4.72^a	31.56 ± 4.51^b	19.82 ± 12.35^b	16.27 ± 4.69^a
3.	11.26 ± 3.89^a	11.40 ± 6.10^a	11.32 ± 4.84^a	7.6 ± 12.788^c	27.87 ± 11.59^b	20.53 ± 5.80^b
4.	16.12 ± 9.19^a	12.90 ± 3.62^a	13.49 ± 5.52^a	47.30 ± 16.05^d	32.74 ± 6.99^b	33.18 ± 6.17^b
5.	21.82 ± 11.35^b	18.91 ± 10.53^a	19.31 ± 6.39^b	66.98 ± 3.32^d	47.44 ± 11.29^c	38.10 ± 3.98^b
6.	24.60 ± 17.53^b	21.48 ± 16.45^b	21.55 ± 7.89^b	78.22 ± 14.58^d	51.57 ± 20.22^c	47.55 ± 11.09^c
7.	19.19 ± 8.46^b	16.58 ± 4.95^a	19.09 ± 1.14^b	88.81 ± 9.67^d	60.69 ± 23.90^c	47.55 ± 11.09^c
8.	20.76 ± 7.31^b	19.28 ± 2.96^b	20.74 ± 4.02^b	97.22 ± 5.56^d	64.56 ± 18.52^c	59.46 ± 16.42^c
9.	24.10 ± 5.41^b	20.75 ± 5.84^b	22.31 ± 4.19^b	97.22 ± 5.56^d	68.31 ± 16.53^c	69.55 ± 17.73^c
10.	25.67 ± 8.29^b	23.70 ± 4.72^b	26.28 ± 2.77^b	99.3 ± 8.30^d	69.70 ± 24.92^c	75.48 ± 15.82^c
11.	26.79 ± 2.52^b	23.61 ± 1.96^b	31.77 ± 11.65^b	101 ± 12.0^d	80.43 ± 27.68^d	87.94 ± 17.06^d
12.	33.48 ± 3.15^b	26.74 ± 6.39^b	39.71 ± 14.56^c	98 ± 12.0^d	80.00 ± 18.1^d	90 ± 14.14^d
13.	40.02 ± 3.57^c	29.86 ± 10.80^b	39.71 ± 14.56^c	110 ± 7.70^d	83.34 ± 23.57^d	96.67 ± 4.72^d
14.	43.75 ± 8.84^c	29.86 ± 10.80^b	44.71 ± 21.63^c	100 ± 9.00^d	103 ± 12.00^d	100 ± 8.00^d

Values with different superscript are significant across rows and columns at α = 0.05.

SSS = Silver sulphadiazine.

Fig. 2 Photomicrographs of electroscalpel wounds at day 7: A – (SSD) shows moderate granulation tissue (blue arrow). B – (Control) show granulation tissue (blue arrow). C (Honey) shows presence of marked cellular infiltrates (black arrow) and granulation tissue (blue arrow). HE ×400.

Fig. 3 Photomicrographs of coldscapel wound at day 7: A – (SSD) shows severe granulation (blue arrow), and moderate angiogenesis (white arrow). B (Control) shows moderate granulation (blue arrow), and moderate angiogenesis (white arrow). C (Honey) shows epithelialization (green arrow), moderate granulation (blue arrow), mild angiogenesis (thin arrow) and moderate fibrosis. HE ×400.

Table 3 Wound histologic indices and inflammatory cell counts of electroscalpel and cold scalpel induced wounds in rats at day 5, 7 and 14.

Parameters	Electroscalpel			Cold scalpel
	SSD	CONTROL	HONEY	SSD	CONTROL	HONEY
Day 5
Granulation tissue	3.00 ± 0.10^a	3.00 ± 0.20^a	3.00 ± 0.13^a	3.00 ± 0.20^a	3.00 ± 0.30^a	2.00 ± 0.10^a
Vascularization	2.00 ± 0.06^a	2.00 ± 0.10^a	2.00 ± 0.11^a	2.00 ± 0.06^a	2.00 ± 0.10^a	1.00 ± 0.07^a
Fibro-elastic tissue	0.00 ± 0.00^a	0.00 ± 0.00^a	0.00 ± 0.00^a	0.00 ± 0.00^a	0.00 ± 0.00^a	0.00 ± 0.00^a
Epithelialization	0.00 ± 0.00^a	0.00 ± 0.00^a	1.00 ± 0.01^a	0.00 ± 0.00^a	0.00 ± 0.00^a	2.00 ± 0.10^a
Macrophages	20 ± 8.49^a	43.0 ± 11.31^b	27.50 ± 2.12^a	7.5 ± 3.54^a	15.0 ± 21.21^a	29.5 ± 4.95^b
Neutrophils	16.5 ± 0.71^a	28.5 ± 0.71^b	20.50 ± 3.54^a	2.5 ± 3.54^a	8.5 ± 12.02^a	19.0 ± 24.0^a
Lymphocytes	15.0 ± 1.41^a	21.0 ± 16.97^a	32.00 ± 4.24^b	10.5 ± 2.12^a	20.0 ± 28.3^a	31.0 ± 7.1^a
Mast cells	3.0 ± 4.24^a	0.0 ± 0.00^b	6.00 ± 5.66^c	10.5 ± 6.4^c	0.00 ± 0.00^b	0.0 ± 0.00^b
Fibroblast	200 ± 28.5^a	78.0 ± 14.14^b	200 ± 15.80^a	10.0 ± 4.2^c	66.0 ± 77.8^b	200.0 ± 25.0^a
Day 7
Granulation tissue	1.00 ± 0.03^a	3.00 ± 0.30^b	3.00 ± 0.20^b	3.00 ± 0.10^b	2.00 ± 0.10^a	1.00 ± 0.04^a
Vascularization	1.00 ± 0.10^a	2.00 ± 0.10^a	1.00 ± 0.10^a	2.00 ± 0.08^a	1.00 ± 0.03^a	1.00 ± 0.08^a
Fibro-elastic tissue	2.00 ± 0.10^a	0.00 ± 0.00^b	0.00 ± 0.00^b	0.00 ± 0.00^b	0.00 ± 0.00^b	1.00 ± 0.03^a
Epithelialization	1.00 ± 0.05^a	0.00 ± 0.00^a	3.00 ± 0.20^b	1.00 ± 0.06^a	2.00 ± 0.10^b	2.00 ± 0.20^b
Macrophages	9.50 ± 4.94^a	18.0 ± 4.24^b	14.50 ± 14.85^a	27.5 ± 7.8^b	23.3 ± 9.89^b	16.5 ± 9.19^a
Neutrophils	7.50 ± 7.77^a	7.0 ± 5.65^a	2.50 ± 3.53^a	11.5 ± 7.78^a	9.5 ± 3.54^a	6.5 ± 9.19^a
Lymphocytes	20.0 ± 25.5^a	15.0 ± 2.82^a	11.00 ± 11.31^a	19.5 ± 0.71^a	21.0 ± 11.3^a	23.5 ± 23.3^b
Mast cells	7.00 ± 4.24^a	0.0 ± 0.00^b	0.00 ± 0.00^b	0.00 ± 0.00^b	0.00 ± 0.00^b	0.00 ± 0.00^b
Fibroblast	30.5 ± 20.5^a	37.0 ± 19.8^a	116.5 ± 118.1^b	146.5 ± 76^b	156.0 ± 0.0^b	62.2 ± 21.0^b
Day 14
Granulation tissue	0.00 ± 0.00^a	2.00 ± 0.20^b	1.00 ± 0.01^a	0.00 ± 0.00^a	0.00 ± 0.00^a	0.00 ± 0.00^a
Vascularization	1.00 ± 0.10^a	2.00 ± 0.08^b	1.00 ± 0.10^a	0.00 ± 0.00^a	0.00 ± 0.00^a	0.00 ± 0.00^a
Fibro-elastic tissue	2.00 ± 0.20^a	0.00 ± 0.00^b	2.00 ± 0.10^a	2.00 ± 0.10^a	2.00 ± 0.10^a	3.00 ± 0.20^a
Epithelialization	2.00 ± 0.10^a	1.00 ± 0.05^b	3.00 ± 0.20^a	3.00 ± 0.10^a	3.00 ± 0.20^a	3.00 ± 0.10^a
Macrophages	21.0 ± 18.4^a	18.0 ± 2.83^a	18.00 ± 2.83^a	36.5 ± 14.9^b	24.5 ± 4.95^a	13.0 ± 11.3^a
Neutrophils	10.0 ± 14.1^a	27.0 ± 24.04^b	2.00 ± 2.83^a	8.0 ± 5.7^a	10.5 ± 2.12^a	3.5 ± 4.95^a
Lymphocytes	29.0 ± 12.7^a	21.0 ± 1.31^a	37.50 ± 21.9^b	35.5 ± 6.4^b	26.0 ± 4.24^a	16.5 ± 2.1^a
Mast cells	3.50 ± 5.0^a	0.0 ± 0.00^a	0.00 ± 0.00^a	5.5 ± 7.8^a	2.5 ± 3.54^a	0.5 ± 0.71^a
Fibroblast	113.5 ± 60^a	114.5 ± 108.2^a	147.50 ± 74.3^a	200.0 ± 0.0^b	129.5 ± 99.7^a	94. ± 11.3^a

Values with different superscript are significant across rows at α = 0.05.

SSS = Silver sulphadiazine.

Fig. 4 Photomicrographs of electroscalpel wounds at day 14: A (SSD) shows granulation (asterick), moderate contraction and epithelialization (blue arrow). B (Control) shows abundant granulation tissue (asterick) with loose connective tissue and no contraction. C (Honey) shows wound contraction (white arrow), moderate granulation (asterick), angiogenesis and epithelialization (blue arrow) HE ×400.

Fig. 5 Photomicrographs of coldscapel wound at day 14: A (SSD) shows complete epithelialization (blue arrow) and wound contraction. B (Control) shows granulation tissues (asterick), and moderate angiogenesis. C (Honey) shows complete epithelialization (blue arrow) and loose connective tissue. HE ×400.