Kaboodkhani Reza, Zandifar Zohre, Owji Seyed Hossein, Koohi-Hosseinabadi Omid, Owji Seyed Mohammad, Yousefi Sarah, Mohammadi Oshnari Abbas, Taheri Salman, Mohammadi Ali Asghar, Asmarian Naeimeh Sadat
Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran.
Otorhinolaryngologist and Head and Neck Surgeon, Private Practice, Shiraz, Iran.
Iran J Otorhinolaryngol. 2025;37(4):187-196. doi: 10.22038/ijorl.2025.80060.3690.
Chitosan, which is an amino polysaccharide resulting from the deacetylation of chitin, regarding its biomedical features such as antioxidant activity, muco-adhesive and hemostatic properties, antibacterial and anti-inflammatory effects, used for medical purposes. Oral cavity and oropharynx are two important structures that in terms of rich blood supply, hemorrhage might be life threating requiring effective hemostatic management. In present study, we evaluated the effect of chitosan dressing on oral cavity wound healing and hemostasis.
Nine male dogs were selected simple randomized and divided into three groups. A wound was made in the buccal mucosa bilaterally. We used chitosan powder dressing on the right side, chitosan-free gaze was used on the left side and bleeding time was determined. Three Dogs after5, three dogs after 10, and three dogs after15 days underwent biopsy bilaterally and pathologic assessment performed. Continuous and ordinal variables were reported as a median and IQR, and Wilcoxon test, and Friedman test were used to analyzing. Data were analyzed using SPSS 21.
Statistical analysis (Wilcoxon test) showed that the overall differences between two groups were statistically significant for (Acute inflammation score: P=.025; Collagenization score: P=.046; Neovascularization score: P=.046; Granulation tissue: P=0.046, and Re-epithelialization score: P=0.038). Chitosan powder dressing application significantly reduced acute inflammation and neovascularization, and increased collagenization, granulation tissue and re-epithelialization. Furthermore, the median time of bleeding and percentage change of wound size which were not statistically significant for all 3days in the case and control groups but they were clinically significant.
Chitosan salt powder dressing positively impacts the wound bleeding control and on mucosal wound healing according to histopathologic and gross wound healing indexes.
壳聚糖是由甲壳素脱乙酰化产生的一种氨基多糖，因其具有抗氧化活性、粘膜粘附性和止血特性、抗菌和抗炎作用等生物医学特性而被用于医学目的。口腔和口咽是两个重要结构，鉴于其丰富的血液供应，出血可能会危及生命，需要有效的止血处理。在本研究中，我们评估了壳聚糖敷料对口腔伤口愈合和止血的影响。
选择9只雄性犬，采用简单随机分组法分为三组。在双侧颊粘膜上制造伤口。右侧使用壳聚糖粉末敷料，左侧使用无壳聚糖的纱布，并测定出血时间。5天后3只犬、10天后3只犬和15天后3只犬双侧进行活检并进行病理评估。连续变量和有序变量以中位数和四分位数间距报告，采用Wilcoxon检验和Friedman检验进行分析。数据使用SPSS 21进行分析。
统计分析（Wilcoxon检验）表明，两组之间在以下方面的总体差异具有统计学意义（急性炎症评分：P = 0.025；胶原化评分：P = 0.046；新血管形成评分：P = 0.046；肉芽组织：P = 0.046；再上皮化评分：P = 0.038）。壳聚糖粉末敷料的应用显著减轻了急性炎症和新血管形成，并增加了胶原化、肉芽组织和再上皮化。此外，出血的中位时间和伤口大小的百分比变化在病例组和对照组的所有3天中虽无统计学意义，但具有临床意义。
根据组织病理学和伤口大体愈合指标，壳聚糖盐粉末敷料对伤口出血控制和粘膜伤口愈合有积极影响。
