Effect of Prednicarbate On the Hyper Proliferation of the Granulation Tissue of Traumatic Wounds During Directed Healing: A Prospective Observational Study

Abstract

Background: The directed scarring of traumatic wounds in a surgical department often encounters drifts. During the proliferation phase, the granulation tissue can become excessive, blocking re-epithelialization and dooming a skin graft. To cope with this, healthcare teams often use topical corticosteroids such as Prednicarbate which is a non- halogenated corticosteroid which does not pass into the systemic circulation. Purpose: The aim of this study is to describe the in vivo effect of Prednicarbate on the hyper proliferation of granulation tissue in trauma wounds and burns during directed scarring. Methods: A prospective observational study was carried out on patients admitted consecutively to the Orthopaedic and Trauma Surgery Department of Aristide le Dantec Hospital in Dakar. The application of 0.25% prednicarbate was twice daily on the hyperprofiltration areas of the wound bed of consenting patients. Demographic, clinical, therapeutic data and changes in granulation tissue were collected. Results: 12 patients participated with an average age 41.5 ± 18.94 years and a female to male sex ratio of 3/1. Domestic accidents were the most common wound occurrence in 7 cases. After at least 3 applications, the modifications observed were as follows: the proportion of hyper-budding surface was reduced by 3% on average. In 8 cases, the bed turned pink, with a texture changing from smooth to granite in 10 cases. A regression of the edema of the bed was observed in all the cases and the level of the bed of the wound which initially known epidermal, became epidermal in 10 cases. In 10 cases, the start of epidermal migration was observed from the skin edges. In 9 cases, or 75% of cases, it took just 1 tube to see a reduction in granulation tissue. Conclusion: Prednicarbate is a non-halogenated corticosteroid which is of interest in reducing the excessive proliferation of granulation tissue in traumatic wounds. By normalizing the level of granulation tissue, it promotes epidermal migration and the epithelialization phase.