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Aim/background: Although many agents have been tested as treatment options for caustic esophageal burn (CEB), none have successfully suppressed the formation of strictures. Thus,the purpose of this study was to determine the efficacy of Contractubex® gel (10% onion extract, 50 U/gr heparin, and 1% allantoin) in stricture preventing after CEB., Methods: In this study, 24 Wistar-albino rats were divided into 4 groups. CEB was initiated with an instillation of 1 mL of 10% NaOH solution into the an isolated esophageal segment for 3 min. Group C (control) was uninjured and untreated. In Group CEB, was initiated but no treatment was given. In Groups CTX 1 and CTX 2 , the animals received 100 and 200 mg/kg/d, respectively, of Contractubex® for 4 weeks via gavage after CEB was initiated. The stenosis indices (SI), histopathologic damage scores, tissue hydroxyproline (HP) levels, and weights of the rats were taken before the experiment and 4 weeks after the experiment., Results: The Mean SI levels, HP levels, and histopathologic damage scores were statistically lower in Groups CTX 1 and CTX 2 when compared with Group CEB (p <0.05). The treatment groups increased in weight when compared to Group CEB. The results were similar between Group CTX 1 and Group CTX 2 (p >0,05); the efficacy of the treatment was not dose-dependent., Conclusion: For the first time, Contractubex® was used for its antifibrotic, antioxidant, anti-inflammatory, and wound healing effects to treat caustic esophageal burn in rats. It was effective in reducing stricture formation by decreasing the HP levels and histopathologic damage as well as preventing stenosis and weight gain in the treatment groups., (Copyright © 2020 IMSS. Published by Elsevier Inc. All rights reserved.)

Background: Postoperative epidural adhesion is a frequent cause of failed back surgery syndrome, manifesting with back and leg pain or neurologic deficits. Development of preventive measures for epidural adhesion after laminectomy is critical to improve outcomes of lumbar surgery. We hypothesized that positive effects of topical application of Contractubex (CTX) gel and benzothiazole (BT) individually and in combination could aid in preventing epidural fibrosis in a rat laminectomy model., Methods: Rats were randomly assigned to 2 control and 5 experimental groups (n = 8 for each group). The control(-) group received no surgery, whereas the control(+) group underwent laminectomy without any drug administration. In experimental groups, study agents applied to dura mater after laminectomy were 100mgCTX, 2.5%BT, 5%BT; 100mgCTXplus2.5%BT, and 100mgCTXplus5%BT. Laminectomy was performed at the L3 level for all rats. The extent of epidural fibrosis was assessed 4 weeks later macroscopically and histopathologically. Hepatic and renal toxicity of study drugs was assessed histopathologically., Results: Topical CTX and BT individually and in combination reduced epidural fibrosis after laminectomy in rats. Although a meaningful decrease of epidural fibrosis with individual application of CTX and BT (2.5% or 5%) was obtained (P < 0.05), the effect of their combination was more pronounced without meaningful hepatic and renal toxicity (P < 0.05)., Conclusions: Combined use of topical CTX and BT could be a potential therapy for epidural fibrosis. Further research with this agents for the prevention of epidural fibrosis is warranted., (Copyright © 2018 Elsevier Inc. All rights reserved.)

In this study, we evaluated the effects of silicone-based gel on the healing of hypertrophic scars in the rabbit ear model. After 4-week application of silicone-based gel containing allantoin, dexpanthenol and heparin (Noscarna™) to scars in a rabbit ear model of hypertrophic scarring, significant improvements in hypertrophic scar healing and a great loss of skin pigment were observed compared to the non-treated control, base or silicone control-treated scars. Furthermore, histological analysis of Noscarna™-treated scars revealed a significant reduction in scar elevation index (SEI), anterior skin and epithelial thicknesses, inflammatory cells, vessels, collagen disorganization and fibroblasts compared to all control hypertrophic scars. Furthermore, Noscarna™ showed more favorable effects on hypertrophic scars than a commercial product, Contractubex®. Therefore, these results clearly demonstrated that the newly developed silicone-based gel, Noscarna™, could be a promising formulation as an effective therapeutic agent for hypertrophic scars.

Aim: Epidural fibrosis following a laminectomy procedure is a serious problem that results in failed back surgery syndrome. Aserious number of manuscripts have explained its possible mechanism and results but no effective preventive surgical technique or treatment is currently present., Material and Methods: We used a rat hemilaminectomy model at lumbar fourth level. In the treatment group (n:10), the hemilaminectomy sites were filled with cepea extract-allantoin and heparin mixture as sterile cream form. In the second group, the same surgical procedure was performed and the site was filled with physiological saline. All animals were terminated after 6 weeks and laminectomy sites removed en-bloc. Epidural fibrosis was evaluated and compared using semi-quantitative histopathological scoring scales., Results: In the physiological saline group, the fibrosis score was 10.3 points and 90% of the subjects had acute inflammatory reaction, 80% chronic inflammatory reaction and 100% showed bone destruction and reparation process. In the cepea extract group, these values were fibrosis score 4.2 points, 0% acute inflammatory reaction, 33.3% chronic inflammatory reaction and 10% bone destruction and reparation process, respectively., Conclusion: This study showed that aloe cepea extract-allantoin and heparin mixture diminished epidural scarring formation effectively with decreased scores of acute and chronic inflammation, compared to the physiological saline solution group.

Cepan Cream is used for the topical treatment of scars and keloids resulting from burns, post-operative scars, and contractures. Cepan Cream makes scars more elastic, softer and paler. Plant extracts, heparin and allantoin in Cepan act on the biochemical processes in the developing connective tissue, preventing the formation of hyperplastic scars. These active ingredients enhance swelling, softening and loosening of connective tissue. It exerts softening and smoothing action on indurated and hyperplastic scar tissue, improving collagen structure. It promotes tissue regeneration and reduces exuberant granulation. Cepan is well tolerated.

Scar development was investigated in 45 young patients who had undergone thoracic surgery. Patients were randomly assigned either to a group which was treated topically with Contractubex gel (Merz + Co., D-Frankfurt/Main), containing 10% onion extract, 50/U of sodium heparin per one g of gel and 1% allantoin, or to a group receiving no treatment. The treatment began on average 26 days after the operation and was continued for one year. The scars of all treated and untreated patients were evaluated at monthly intervals. The appearance of the scar, including scar type and scar size as well as scar colour, was assessed by the physician. A reduction of the increase of scar width was seen in the Contractubex-treated group as compared with the untreated group. Further, physiological scars and skin-coloured scars were more frequent in the treated group than in the untreated group. Hypertrophic or keloidal scars were less frequent in the treated group. No differences in scar length and scar height were seen. At the end of the observation period, the clinical course of scar development was rated as "very good" or "good" in more than 90% of the treated patients, "good" in less than 40% and "moderate" or "bad" in more than 60% of the untreated cases. The tolerability of the drug was "good" or "very good" in all cases. In conclusion, Contractubex gel is useful in scar treatment after thoracic surgery.

Compared to the ointment base, the application of a heparin-allantoin-dexpanthenol combination ointment (Hepathrombin ointment) to guinea pigs immediately after as well as 30 and 120 min prior to UV-irradiation effects more rapid regression of the erythema along with a reduction in erythema formation. After a pretreatment of 30 min, the temperature of the erythematous skin is also significantly lower. At a pretreatment of 120 min, no temperature differences can be observed between the ointment groups. This effect might result from a superimposition of the anti-erythematous/antiinflammatory effect of Hepathrombin along with a vasodilation effect on the deeper skin layers. The antiinflammatory effect of Hepathrombin is also discussed in connection with the mechanism of UV-induced erythema. The inhibition of UV-erythema by Hepathrombin underlines the rapid skin penetration of the active substances.

Experimentally induced thrombi of ear veins in albino rabbits have been treated locally with heparin-containing ointments in presence or absence of allantoin and dexpanthenol, the heparin concentration varying. While the ointments, containing heparin only, induce no or only minor thrombolytic activity, the combination ointments Hepathrombin Adenylchemie containing heparin, allantoin and dexpanthenol show significant thrombolytic activity. This effect is dependent upon the heparin concentration, yet, heparin doses above 50 000 IU per 100 g of ointment do not enhance the thrombolysis furthermore. Further, the studies show that the effective components of Hepathrombin do penetrate into and through the skin, allantoin and dexpanthenol being important components of the ointment probably supporting the transdermal penetration of heparin. The studies also demonstrate the only local thrombolytic effect of the Hepathrombin ointments because the thrombus of the right ear, always treated with ointment base only, did not show any change in length as contrasted to that of the left ear of the same animal treated with the Hepathrombin ointments. Mechanisms of the locally by Hepathrombin/heparin induced thrombolysis will be discussed.

Local application of a heparin-allantoin-dexpanthenol (Hepathrombin-Adenylchemie) ointment to rats 15 min prior to induction of a passive cutaneous anaphylaxis (PCA) reaction inhibits the anaphylactic reaction as compared to the ointment base. Also, the Evans Blue content as a measure for vascular permeability and the oedema weights are reduced under the heparin containing ointment. The antiallergic/antiinflammatory effect is probably due to heparin.