Efeitos de extrato etanólico de folhas de Piper amalago, Piper vicosanum e Piper glabratum em modelo de ferimentos descolantes em ratos wistar

Abstract

Degloving injuries are a specific category of soft tissue injuries, typically caused by a combination of pressure and rotation mechanisms. This type of trauma results in the formation of skin flaps with uncertain vascularization, complicating the decision-making process for therapeutic interventions. The standard treatment for complex degloving involves converting the detached skin into a skin graft; however, this approach has numerous limitations, particularly related to the vitality of the recipient site, which often fails to provide ideal conditions for graft integration. Furthermore, skin graft treatments may lead to inadequate epithelial coverage, resulting in thin and trauma-prone skin. Therefore, any intervention that enhances the viability of traumatized tissues may offer advantages in managing degloving injuries. The objective of this study was to assess the effect of three ethanolic extracts from the leaves of plants belonging to the Piper genus in an animal model of avulsion wounds in Wistar rats, with a focus on reducing the extent of cutaneous necrosis and addressing acute aspects of healing. The Piper genus, a member of the Piperaceae family, comprises angiosperms that manifest as shrubs, trees, herbs, or climbers, primarily distributed in tropical zones worldwide. The most common traditional medicinal use of Piperaceae plants is in the treatment of pain and inflammation, supported by scientific literature with numerous studies demonstrating positive biological effects in these and other situations. In this study, degloving wounds were induced according to the experimental model proposed by Milcheski (2010), employing a surgical procedure under general anesthesia with ketamine and xylazine. Animals received daily treatments with ethanolic extracts from the leaves of Piper amalago, Piper glabratum, and Piper vicosanum orally through gavage. A positive control group underwent hyperbaric oxygenation with daily sessions in a hyperbaric chamber at 100% oxygen and 2.5 ATM pressure. A SHAM group received no additional treatment, while the negative control group received 0.9% saline solution daily by gavage. All animals were euthanized on the 7th postoperative day, and cutaneous flaps were excised and measured for areas of cutaneous necrosis. The flaps were also subjected to histopathological analysis. The percentage of cutaneous necrosis in the avulsed flaps was, respectively (measured in cm2 ± SE): SHAM group = 62.84% ± 6.38%; negative control group = 63.03% ± 4.11%; EEPV = 40.80% ± 4.76, p<0.05; EEPG = 32.97% ± 4.01, p<0.01; EEPA = 32.40% ± 4.61, p<0.01; OH = 33.21% ± 4.29, p<0.01. Histopathological analysis revealed signs of improvement in certain healing parameters, such as reduced edema, increased collagen deposition, and predominantly mononuclear inflammatory infiltrate, indicating a more advanced healing process. The ethanolic extracts from the leaves of P. amalago, P. glabratum, and P. vicosanum demonstrated beneficial potential in reducing cutaneous necrosis in the tested model. The outcomes in these groups were comparable to hyperbaric oxygenation, a therapy that, despite being established in treating complex wounds, still incurs high financial costs, making the possibility of implementing therapies derived from plant extracts an interesting alternative.