Combinatory effects of twig emulgel: Wound-restoring, antibacterial, and anti-inflammatory activities against methicillin-resistant infected mouse superficial wounds.

has been used for the treatment of infectious skin diseases and ulcerative wounds in Thai traditional medicine. A major pathogen in human superficial skin infections is methicillin-resistant (MRSA). This study determined the wound healing, antibacterial, and anti-inflammatory activities of twig emulgel against MRSA-infected mouse superficial skin wounds. Ethyl acetate-methanol crude extract of twig was incorporated into emulgel at concentrations of 20 and 40 mg/g (D20 and D40) and its activity was compared to tetracycline emulgel (160 μg/g, Tetra). MRSA-infected superficial wounds demonstrated decreased skin barrier strength, increased transepidermal water loss (TEWL), and mast cell accumulation. Expression of toll-like receptor 2 (TLR-2), NF-κβ, TNFα, IL-1β, IL-6 and IL-10 genes were induced after MRSA infection. Daily application of 100 μL of D20 or D40 for 9 days restored skin barrier strength and TEWL while reducing mast cell and MRSA numbers compared to the non-treated group (MRSA-NT). The wounds treated with D20 and D40 were entirely healed on day 9. Expression of TLR-2 and cytokine-related genes NF-κβ, TNFα, IL-1β, IL-6 and IL-10 were normalized by treatment with either D20 or D40. Therefore, emulgel containing 20 to 40 mg/g ethyl acetate-methanol crude twig extract is a good candidate for development as a topical formulation for MRSA-infected ulcerated wounds.