(Comment on an article - see below link).
Pistacia is a genus of the family Anacardiaceae. The plant has played an important role in traditional medicine and has been used in treatment of several diseases. In some countries the resin of Pistacia is used as wound dressing. As herbal medicine is usually safe and not expensive and also according to voluble traditional experiences, researchers have tried to assess the real effect of this part of medicine [1].
In our previous study [1] we have cited an article done by Djerrou et al that is a survey on the effect of Pistacia lentiscus virgin fatty oil on the burning wound healing. They have reported that the oil promotes wound contraction and reduces epithelization period in rabbit model [2]. They have created burn wounds on the back of rabbits (four burn wound for each animal) and divided them into four groups. The groups were treated by Pistacia lentiscus virgin fatty oil (PLVFO), Madecassol (MAD), Vaseline (VAS) and nothing (CRL) as a control group and finally wound contraction and epithelization were assessed. They have reported that “both PLVFO and Madecassol significantly accelerated wound healing activity compared to wounds dressed with Vaseline and the untreated wounds. Also the level of wound contraction was significantly higher and the healing time was faster in PLVFO group than those of the MAD group, VAS group and CRL group”. In our article [1] we have reported that “Djerrou et al. revealed that Pistacia lentiscus virgin fatty oil significantly promotes wound contraction and reduces epithelialization period in rabbit model”. According to their results mean±SD of wound contraction (%) in the final day of the study were 96.93±4.95, 93.78±10.98, 87.49±13.76 and 83.40±12.85 for PLVFO, MAD, VAS and CRL groups respectively (P‹0.05) and they have reported that PLVFO has higher wound contraction so it has better effect of burn wound healing.
According to table 1 and also figure 1 of the mentioned paper [2], from the 4th day of the study PLVFO had a better wound contraction. From the beginning of the study there was a significant difference between groups and the difference is remained till the end of the study. Interestingly there is a pattern for wound contraction in all four groups and they all have the same shape. I think for better analysis, the wound size in the first day and analysis of the differences is important. If wound size of PLVFO be significantly smaller in the first day than other groups, with the same decreasing in the wound size in the four groups, wound contraction of PLVFO will be higher than the others. In addition when we calculate the increasing of wound contraction within the study (28th day-4th day), the results will be 60.44 (96.93-36.49), 61.42 (93.78-32.36), 75.20 (87.49-12.29) and 54.03 (83.4-29.37) for PLVFO, MAD, VAS and CRL groups respectively. According to this analysis, VAS group has a better improvement of wound contraction and CRL is the worst.
In conclusion I recommend the authors to re-analyze the data and report them for better conclusion.
References
1. Haghdoost F, Baradaran Mahdavi MM, Zandifar A, Sanei MH, Zolfaghari B, Javanmard SH. “Pistacia atlantica Resin Has a Dose-Dependent Effect on Angiogenesis and Skin Burn Wound Healing in Rat,” Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 893425, 8 pages, 2013. doi:10.1155/2013/893425.
2. Djerrou Z, Maameri Z, Hamdi-Pacha Y, Serakta M, Riachi F, Djaalab H, et al. Effect of virgin fatty oil of Pistacia lentiscus on experimental burn wound's healing in rabbits. Afr J Tradit Complement Altern Med. 2010;7:258-263.
https://www.researchgate.net/publication/50990029_Effect_of_virgin_fatty_oil_of_Pistacia_lentiscus_on_experimental_burn_wound%27s_healing_in_rabbits?ev=srch_pub
Article Effect of Virgin Fatty Oil of Pistacia Lentiscus on Experime...
To: Faraidoon Haghdoost
Hello,
Thank you for your interest. But it seems that you have not understood the experimental protocol.
The authors have created identical circular burns on the back of each animal (Same surface and form) in day 0. The percentage of wound contraction was calculated (see equation) with comparison to initial surface (the same for all wounds). These percentages were shown in table 1 and presented in figure 1. The evaluation was started in day 4 because in day 0 all wounds were similar with % of wound contraction=0. The authors have studied cumulative % of contraction with comparison of the surface of wound with initial surface. They have not focused the variation of the contraction in each period (Ex. Between the 4th and 8th day, the 8th and 12th day…). The authors were convinced that’s impossible to confirm the mechanism of action with 6 rabbits (small number). For this raison they have not focused the difference of this % of contraction between groups in the different periods (which correspond to a step in healing process: inflammatory, proliferative, remodeling…). Several studies which have adopted this kind of comparison with small number of animals have concluded to contradictory results with other studies … If one or two wound’s crust were traumatized by rabbit, the % of contraction may vary consecutively. The individual response may also affect the results….
About vaseline and Madecassol, their mechanism of action (noted in paper) were well documented.
In clinical approach, the epithelization period (healing time) seems to be most stable parameter to evaluate the healing process with comparison to the evolution of wound contraction percentage. Our team is now working on other approaches (Histo-chemical) to understand the effect of this vegetable oil on healing process: dosage of lysine, proline, hydroxylysine, hydroxyproline…VEGF, PGDF, TGFβ, MMP9…
At the end, I can confirm the effective effect of this oil in healing burs not because 2 or 3 studies have confirmed this pharmacology property in some rabbits but because I have personally seen lot of cases treated successfully with this oil in our local traditional medicine.
Thanks for the complete and in detailed response
After creating the wounds, usually they are not completely identical. Sometimes after analyzing the first day differences, we can find statistically significant differences between groups. So it’s important to report the data of first day and compare them.
Also I agree with your final comment and I am sure about the effect of the plant because I have seen lots of cases that were treated by the plant (Cases of gastric ulcers, burns, dermal injuries and etc).
Best regards
Hello Faraidoon Haghdoost
Really, it is difficult to get similar wounds , particularly in the case of excisional wounds. But some research teams use an electric ablation system (discoid) to obtain identical wounds. For our case (burns), we usually use more animals and after experimental procedure, we choose animals that have the most similar wounds (no significant differences) to implicate them in the study.
Best regards!
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