Investigation of the Effect of Ankaferd Blood Stopper on Wound Healing of Donor Site

Yıl 2023, Cilt: 5 Sayı: 2, 75 - 82, 28.08.2023

Ahmet Cemil Talmaç , Dicle Altındal , Metin Çalışır , Bilal Ege

Öz

Aim: The aim of this study is to evaluate the effect of Ankaferd Blood Stopper (ABS) on the palatal donor site following free gingival graft (FGG) surgery.
Materials and Methods: A total of 12 patients (24 palatal sites) were included in the study. In each patient, the donor sites were randomly divided into two groups. ABS+collagen pad was applied to test group. Only collagen pad was applied to control group. Donor sites were evaluated in terms of bleeding, epithelialization, sensitivity, pain score, analgesic usage, wound size, wound healing (LTH) index, and tissue thickness (TT).
Results: Intraoperative bleeding was observed in significantly more patients (n=9) in the control group, while it was not observed in any of the patients in the test group (p=0.000). Although higher epithelialization (33.3%) was detected in the test group on day 14th, there was no significant difference in epithelization between the groups. There was no significant difference in pain score, analgesic usage, wound size, LTH index, and TT between the groups. When the amount of change between the times was analysed, only the change in TT between the 21st day and the 6th week was found to be statistically significant (p=0.028).
Conclusion: In our study, it can be said that the use of ABS following FGG surgery has a positive effect on intraoperative bleeding, short-term epithelialization and long-term TT but it cannot provide an effective superiority compared to collagen sponge alone in terms of early wound healing, postoperative pain, and analgesic usage.

Anahtar Kelimeler

Ankaferd hemostatic, free gingival graft, wound healing

Destekleyen Kurum

YOK

Proje Numarası

YOK

Teşekkür

Authors of this study thank to Prof. Dr. Sıddık Keskin (Department of Biostatistics, Faculty of Medicine, Van Yuzuncu Yil University)

Ankaferd Kanama Durdurucunun Donör Bölgede Yara İyileşmesi Üzerine Etkisinin İncelenmesi

Öz

Amaç: Bu çalışmanın amacı, serbest dişeti grefti (SDG) cerrahisi sonrası palatinal donör alanda Ankaferd Blood Stopper (ABS) kullanımının etkisini değerlendirmektir.
Gereç ve Yöntemler: Toplam 12 hasta (24 palatal bölge) çalışmaya dahil edildi. Her hastada donör bölgeler rasgele iki gruba ayrıldı. Test grubuna ABS+kollajen ped uygulandı. Kontrol grubuna ise sadece kollajen ped uygulandı. Kanama, epitelizasyon, duyarlılık, ağrı skoru, alınan analjezik sayısı, yara boyutu, yara iyileşme (LTH) indeksi ve doku kalınlığı (DK) açısından donör sahalar değerlendirildi.
Bulgular: İntraoperatif kanama bakımından kontrol grubunda anlamlı şekilde daha fazla hastada (n=9) kanama gözlenirken; test grubunda hiçbir hastada gözlenmedi (p=0.000). Test grubunda 14. günde daha yüksek epitelizasyon varlığı (33.3%) tespit edilmesine ragmen, epitelizasyon bakımından gruplar arasında anlamlı bir farklılık tespit edilmedi. Gruplar arasında ağrı skorları, analjezik kullanımı, yara boyutu, LTH indeksi ve DK bakımından anlamlı bir farklılık tespit edilmedi. Zamanlar arasındaki değişim miktarı incelendiğinde sadece 21. gün ile 6. hafta arasındaki TT’deki değişim, istatistiksel olarak anlamlı bulundu (p=0,028).
Sonuç: Çalışmamızda SDG cerrahisi sonrasında ABS kullanımının intraoperatif kanama, kısa dönem epitelizasyon ve uzun dönem DK’da olumlu etkisinin olduğu ancak erken dönem yara iyileşmesi, postoperatif ağrı ve analjezik tüketimi konusunda tek başına kollajen süngere kıyasla etkin bir üstünlük sağlayamadığı söylenebilir.

Anahtar Kelimeler

Ankaferd kanama durdurucu, serbest dişeti grefti, yara iyileşmesi

Proje Numarası

YOK

Kaynakça

• 1. Perussolo J, Souza AB, Matarazzo F, Oliveira RP, Araújo MG. Influence of the keratinized mucosa on the stability of peri-implant tissues and brushing dis-comfort: A 4-year follow-up study. Clin Oral Implants Res. 2018;29:1177–85.
• 2. Zucchelli G, Tavelli L, McGuire MK, Rasperini G, Feinberg SE, Wang H, et al. Autogenous soft tissue grafting for periodontal and peri‐implant plastic sur-gical reconstruction. J Periodontol. 2020;91:9–16.
• 3. Wessel JR, Tatakis DN. Patient outcomes following subepithelial connective tissue graft and free gingival graft procedures. J Periodontol. 2008;79:425–30.
• 4. Brasher WJ, Rees TD, Boyce WA. Complications of free grafts of masticatory mucosa. J Periodontol. 1975;46:133–8.
• 5. Keceli HG, Aylikci BU, Koseoglu S, Dolgun A. Evalua-tion of palatal donor site haemostasis and wound healing after free gingival graft surgery. J Clin Perio-dontol. 2015;42:582–9.
• 6. Tavelli L, Ravidà A, Saleh MHA, Maska B, Del Amo FSL, Rasperini G, et al. Pain perception following epi-thelialized gingival graft harvesting: a randomized clinical trial. Clin Oral Investig. 2019;23:459–68.
• 7. Goker H, Haznedaroglu IC, Ercetin S, Kirazli S, Akman U, Ozturk Y, et al. Haemostatic actions of the folkloric medicinal plant extract Ankaferd Blood Stopper. J Int Med Res. 2008;36:163–70.
• 8. Tasdelen Fisgin N, Tanriverdi Cayci Y, Coban AY, Ozatli D, Tanyel E, Durupinar B, et al. Antimicrobial activity of plant extract Ankaferd Blood Stopper. Fitoterapia. 2009;80:48–50.
• 9. Gül M, Günay A, Tanik A. An evaluation of the effects of caffeic acid phenethyl ester and Ankaferd blood stopper on secondary wound healing of oral mucosal tissue. Turk J Med Sci. 2020;50:248–57.
• 10. Çakarer S, Eyüpoğlu E, Günes ÇÖ, Küseoğlu BG, Ber-beroğlu HK, Keskin C. Evaluation of the hemostatic effects of Ankaferd blood stopper during dental ex-tractions in patients on antithrombotic therapy. Clin Appl Thromb Hemost. 2013;19:96–9.
• 11. Evren C, Çinar F, Sarikaya S, Alpay A, Bektas S. Ankaferd “Blood Stopper”in Tükrük Bezi Kanamasın-da Etkinliği Effectiveness of Ankaferd Blood Stopper on Salivary Gland Bleeding. J Kartal TR. 2012;23:1–5.
• 12. Pamuk F, Cetinkaya BO, Keles GC, Balli U, Koyun-cuoglu CZ, Cintan S, et al. Ankaferd blood stopper en-hances healing after osseous grafting in patients with intrabony periodontal defects. J Periodontal Res. 2016;51:540–7.
• 13. Sullivan HC, Atkins JH. Free autogenous gingival grafts. I. Principles of successful grafting. Periodon-tics. 1968;6:121–9.
• 14. Kızıltoprak M, Uslu MÖ. Comparison of the effects of injectable platelet-rich fibrin and autologous fibrin glue applications on palatal wound healing: a ran-domized controlled clinical trial. Clin Oral Investig. 2020;24:4549–61.
• 15. Ustaoglu G, Ercan E, Tunali M. Low-level laser thera-py in enhancing wound healing and preserving tissue thickness at free gingival graft donor sites: a random-ized, controlled clinical study. Photomed Laser Surg. 2017;35:223–30.
• 16. Del Pizzo M, Modica F, Bethaz N, Priotto P, Ro-magnoli R. The connective tissue graft: a comparative clinical evaluation of wound healing at the palatal donor site. A preliminary study. J Clin Periodontol. 2002;29:848–54.
• 17. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17:45–56.
• 18. Landry RG, Turnbull RS, Howley T. Effectiveness of benzydamyne HCl in the treatment of periodontal post-surgical patients. Res Clin Forums. 1988;10:105–18.
• 19. Marini L, Rojas MA, Sahrmann P, Aghazada R, Pilloni A. Early wound healing score: a system to evaluate the early healing of periodontal soft tissue wounds. J Periodontal Implant Sci. 2018;48:274–83.
• 20. Samani MK, Saberi BV, Ali Tabatabaei SM, Moghadam MG. The clinical evaluation of platelet-rich plasma on free gingival graft’s donor site wound healing. Eur J Dent. 2017;11:447–54.
• 21. Tavelli L, Barootchi S, Ravidà A, Oh TJ, Wang HL. What is the safety zone for palatal soft tissue graft harvesting based on the locations of the greater pala-tine artery and foramen? a systematic review. J Oral Maxillofac Surg. 2019;77:271.e1-271.e9.
• 22. Bertl K, Pifl M, Hirtler L, Rendl B, Nürnberger S, Stav-ropoulos A, et al. Relative composition of fibrous connective and fatty/glandular tissue in connective tissue grafts depends on the harvesting technique but not the donor site of the hard palate. J Periodontol. 2015;86:1331–9.
• 23. Zucchelli G, Mazzotti C, Mounssif I, Mele M, Stefanini M, Montebugnoli L. A novel surgical-prosthetic ap-proach for soft tissue dehiscence coverage around single implant. Clin Oral Implants Res. 2013;24:957–62.
• 24. İşler SC, Demircan S, Çakarer S, Çebi Z, Keskin C, Soluk M, et al. Effects of folk medicinal plant extract Ankaferd Blood Stopper® on early bone healing. J Appl Oral Sci. 2010;18:409–14.
• 25. Güler Ş, Cetinkaya BO, Kurt Bayrakdar S, Ayas B, Keles GC. Comparison of the effectiveness of Ankaferd Blood Stopper® and Emdogain in periodon-tal regeneration. Oral Dis. 2022;28:1947–57.
• 26. Kaya, H, Gokdemir, M. T., Sogut, O. Effects of folk medicinal plant extract ankaferd blood stopper on burn wound healing. Acta Medica Mediterranea. 2013;29:497–502.
• 27. Bilgili H, Captug O, Kosar A, Kurt M, Kekilli M, Shor-bagi A, et al. Oral systemic administration of Ankaferd blood stopper has no short-term toxicity in an in vivo rabbit experimental model. Clin Appl Thromb Hemost. 2010;16:533–6.
• 28. Bahammam MA. Effect of platelet-rich fibrin palatal bandage on pain scores and wound healing after free gingival graft: a randomized controlled clinical trial. Clin Oral Investig. 2018;22:3179–88.
• 29. Ozcan M, Ucak O, Alkaya B, Keceli S, Seydaoglu G, Haytac MC. Effects of platelet-rich fibrin on palatal wound healing after free gingival graft harvesting: a comparative randomized controlled clinical trial. Int J Periodontics Restorative Dent. 2017;37:e270–8.
• 30. Dias SBF, Fonseca MVA, Dos Santos NCC, Mathias IF, Martinho FC, Junior MS, et al. Effect of GaAIAs low-level laser therapy on the healing of human palate mucosa after connective tissue graft harvesting: ran-domized clinical trial. Lasers Med Sci. 2015;30:1695–702.