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:: Volume 20, Issue 2 (jrds 2023) ::
J Res Dent Sci 2023, 20(2): 1-7 Back to browse issues page
Efficacy of Topical Phenytoin on Microbial Load of Oral Wounds
Maryam Baharvand , Somaye Mazarei Sotoode2 , Fahimeh Sadat Tabatabaei , Mehdi Yaseri , Massume Heidari , Parisa Hajighasem
Abstract:   (679 Views)
Background and Aim: To treat wounds, various treatment methods are used,including chemical, herbal, homeopathic and laser treatments, the main goal of which is faster, less complication, and at the same time lower cost of wounds. Topical phenytoin also has a positive effect on wound healing.The aim of present study was to investigate the antimicrobial effect of topical 1% phenytoin on microbial contamination caused by microorganisms affecting oral ulcer infection in an animal model.
Material and Methods: In this experimental animal experimental study in 2019, 36 male rafts were selected. After anesthetizing the rats, the mandibular gingiva was flapped. Three types of microbial microorganisms including Candida albicans, Staphylococcus aureus and Actinomycosis were prepared. An equal number of microorganisms was placed at the incision site. Rats were randomly divided into two groups. In 18 rats 1% topical phenytoin powder was applied to the wounds, and in the remaining 18 rats no drug was applied to the wound. Finally, 36 samples of incisal biopsy were cultured in specific media for each microorganism and transferred to the laboratory. Colonies counted in phenytoin groups were compared with non-phenytoin groups. Data were analysed by Mann-Whitney test  by means of SPSS 22 software.
Results: Mean±sd and Pvalue colonies of Staphylococcus aureus case and control groups respectively(124827±301378) and(807±1209),(P=0.259), Candida albicans(1750±1339)and(2357±4679),(P=0.423) and Actinomyces (16088±36721)and(47±114)(P=0.049)were not statistically significant between the phenytoin and control groups.
Conclusion:  It seems that 1% topical phenytoin powder after one use had no effect on reducing the microbial contamination of oral ulcers in laboratory rat.
 
Keywords: phenytoin, microorganism, animal model, wound healing
Full-Text [PDF 659 kb]   (597 Downloads)    
Type of Study: original article | Subject: Oral Medicine
References
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14. 14Muthukumarasamy MG, Sivakumar G, Manoharan G. Topical phenytoin in diabetic foot ulcers. Diabetes Care. 1991;14:909-11. [DOI:10.2337/diacare.14.10.909] [PMID]
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22. Ahadian H, Akhavankarbasi MH, Sabaghzadegan Y. Comparison of the Clinical Effect of Mucoadhesive Cream of Phenytoin and Triamcinolone Acetonide on the Improvement of Minor Aphthous Ulcer. J Mash Dent Sch 2021; 44: 317-27.
23. Baharvand M, Tabatabaei FS, Amiri Andi P, Khodabakhshi A, Sabour S, Mortazavi H. Antimicrobial Effect of Phenytoin on Common Microorganisms Contaminating Oral Ulcers: An In-vitro Pilot Study. J Mazandaran Univ Med Sci 2019; 28: 36-42
24. Hajong R, Naku N, Hajong D, Anand M, Singh KL, Majumdar N. Effect of topical phenytoin on wound healing. IOSR Journal of Dental and Medical Sciences 2016; 15:161-164 [DOI:10.9790/0853-150902161164]
25. Lodha SC, Lohiya ML, Vyas MCR, Bhandari S, Goyal RR, Harsh MK. Role of phenytoin in healing of large abscess cavities. Br J Surg. 1991;78:105-8. [DOI:10.1002/bjs.1800780132] [PMID]
26. Shaw J, Hughes CM, Lagan KM, Bell PM. The clinical effect of topical phenytoin on wound healing: a systematic review. Br J Dermatol. 2007;157:997-1004. [DOI:10.1111/j.1365-2133.2007.08160.x] [PMID]
27. Hao XY, Li HL, Su H, Cai H, Guo TK, Liu R, Jiang L, Shen YF. Topical phenytoin for treating pressure ulcers. Cochrane Database Syst Rev. 2017;2 [DOI:10.1002/14651858.CD008251.pub2] [PMID]
28. Brooks GF, Jawetz E, Melnick JL, Adelberg EA. Jawetz, Melnick, & Adelberg's medical microbiology. New York: McGraw Hill Medical; 2013. p.167, 194, 199, 249, 375-8, 395, 681.
29. Hasamnis A, Mohanty B, Muralikrishna, Patil S. Evaluation of wound healing effect of topical phenytoin on excisional wound in albino rats. J Young Pharm. 2010;2:59-62. [DOI:10.4103/0975-1483.62215] [PMID] [PMCID]
30. Guo S, DiPietro LA. Factors affecting wound healing. J Dent Res. 2010;89:219-29. [DOI:10.1177/0022034509359125] [PMID] [PMCID]
31. Ikram R. Microbiological assessment of infected Wounds:When to take a swab and how to interpret the results. best tests. 2013;19.
32. Shakeri F, Tebyanian H, Karami A, Babavalian H, Tahmasbi MH. Effect of topical phenytoin on wound healing. Trauma Mon 2016; 22:e354488 [DOI:10.5812/traumamon.35488]
33. Lars Andersson K-EK. Oral and Maxillofacial Surgery. UK: Wiley-Blackwell; 2010
34. Asadbegy M, Mirazi N, Vatanchian M. Comparative Study of Lotus corniculatus L. Hydroethanolic Extract and Phenytoin Ointment Effects on Rat Skin Wound Healing: Morphometrical and Histopathological Studies. Journal of Cell & Tissue (JCT) 2011; 2: 213-223
35. Ghapanchi J, Haghighi F, Dehpour Gh. Effect of Phenytoin on healing of periodontal surgical wounds. J Dent Shiraz Univ Med Sci. 1999;1:36-37
36. Doshi A, McAuley JW, Tatakis DN. Topical phenytoin effects on palatal wound healing. J Periodontol. 2021 ;92:409-418. [DOI:10.1002/JPER.20-0340] [PMID]
37. Hokkam E, El-Labban G, Shams M, Rifaat S, El-Mezaien M. The use of topical phenytoin for healing of chronic venous ulcerations. Int J Surg. 2011;9:335-8 [DOI:10.1016/j.ijsu.2011.02.007] [PMID]
38. McBride DR. Management of aphthous ulcers. Am Fam Physician 2000; 62:149-54.
39. Younes N, Albsoul A, Badran D, Obedi S. Wound bed preparation with 10-percent phenytoin ointment increases the take of split-thickness skin graft in large diabetic ulcers. Dermatol Online J 2006; 12:5. [DOI:10.5070/D398T188X0] [PMID]
40. Fonseka HF, Ekanayake SM, Dissanayake M. Two percent topical phenytoin sodium solution in treating pyoderma gangrenosum: a cohort study. Int Wound J 2010;7:519-23. [DOI:10.1111/j.1742-481X.2010.00725.x] [PMID] [PMCID]
41. Fani MM, Ebrahimi H, Pourshahidi S, Aflaki E, Shafiee Sarvestani S. Comparing the effect of phenytoin syrup and triamcinolone acetonide ointment on aphthous ulcers in patients with Behcet's syndrome. Iran Red Crescent Med J 2012; 14:75-8.
42. 14Muthukumarasamy MG, Sivakumar G, Manoharan G. Topical phenytoin in diabetic foot ulcers. Diabetes Care. 1991;14:909-11. [DOI:10.2337/diacare.14.10.909] [PMID]
43. Carneiro PM, Nyawawa ET. Topical phenytoin versus EUSOL in the treatment of non-malignant chronic leg ulcers. East Afr Med J. 2003;80:124-9. [DOI:10.4314/eamj.v80i3.8680] [PMID]
44. Esibu N, Hoosein N. An assessment of the in vitro antimicrobial effects of two antiepileptic drugs--sodium valproate and phenytoin. Antonie Van Leeuwenhoek. 2003;83:63-8. [DOI:10.1023/A:1022992224594] [PMID]
45. Association AP. Guidelines for Ethical Conduct in the Care and Use of Non human Animals in Research.Ethical principles of psychologists and code of conduct (2002, Amended June 1, 2010) 2010 [updated Retrieved September 19, 2011; cited 2010]. Available from: http://www.apa.org/ethics/code/index.aspx
46. Firmino F, de Almeida AM, e Silva Rde J, Alves Gda S, Grandeiro Dda S, Penna LH. A produção científica acerca da aplicabilidade da fenitoína na cicatrização de feridas [Scientific production on the applicability of phenytoin in wound healing]. Rev Esc Enferm USP. 2014;48(1):166-73. [DOI:10.1590/S0080-623420140000100021] [PMID]
47. Modaghegh S, Salehian B, Tavassoli M, Djamshidi A, Rezai AS. Use of phenytoin in healing of war and non-war wounds. A pilot study of 25 cases. Int J Dermatol. 1989;28:347-50. [DOI:10.1111/j.1365-4362.1989.tb01363.x] [PMID]
48. el Zayat SG. Preliminary experience with topical phenytoin in wound healing in a war zone. Mil Med. 1989;154:178-80. [DOI:10.1093/milmed/154.4.178] [PMID]
49. Bhatia A, Prakash S. Topical phenytoin for wound healing. Dermatol Online J. 2004;10:5. [DOI:10.5070/D30Z3612W1] [PMID]
50. Ahadian H, Akhavankarbasi MH, Sabaghzadegan Y. Comparison of the Clinical Effect of Mucoadhesive Cream of Phenytoin and Triamcinolone Acetonide on the Improvement of Minor Aphthous Ulcer. J Mash Dent Sch 2021; 44: 317-27.
51. Baharvand M, Tabatabaei FS, Amiri Andi P, Khodabakhshi A, Sabour S, Mortazavi H. Antimicrobial Effect of Phenytoin on Common Microorganisms Contaminating Oral Ulcers: An In-vitro Pilot Study. J Mazandaran Univ Med Sci 2019; 28: 36-42
52. Hajong R, Naku N, Hajong D, Anand M, Singh KL, Majumdar N. Effect of topical phenytoin on wound healing. IOSR Journal of Dental and Medical Sciences 2016; 15:161-164 [DOI:10.9790/0853-150902161164]
53. Lodha SC, Lohiya ML, Vyas MCR, Bhandari S, Goyal RR, Harsh MK. Role of phenytoin in healing of large abscess cavities. Br J Surg. 1991;78:105-8. [DOI:10.1002/bjs.1800780132] [PMID]
54. Shaw J, Hughes CM, Lagan KM, Bell PM. The clinical effect of topical phenytoin on wound healing: a systematic review. Br J Dermatol. 2007;157:997-1004. [DOI:10.1111/j.1365-2133.2007.08160.x] [PMID]
55. Hao XY, Li HL, Su H, Cai H, Guo TK, Liu R, Jiang L, Shen YF. Topical phenytoin for treating pressure ulcers. Cochrane Database Syst Rev. 2017;2 [DOI:10.1002/14651858.CD008251.pub2] [PMID]
56. Brooks GF, Jawetz E, Melnick JL, Adelberg EA. Jawetz, Melnick, & Adelberg's medical microbiology. New York: McGraw Hill Medical; 2013. p.167, 194, 199, 249, 375-8, 395, 681.
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Baharvand M, Mazarei Sotoode2 S, Sadat Tabatabaei F, Yaseri M, Heidari M, Hajighasem P. Efficacy of Topical Phenytoin on Microbial Load of Oral Wounds. J Res Dent Sci 2023; 20 (2) :1-7
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