Bensal HP Treatment for Burn and Excision Wounds: An In-Vivo Assessment of Wound Healing Efficacy and Immunological Impact

November 2015 | Volume 14 | Issue 11 | Original Article | 1322 | Copyright © November 2015


Jamie Rosen BA,a* Angelo Landriscina BA,a* Anjana Ray PhD,b Lydia Tesfa PhD,b Joshua D. Nosanchuk MD,b and Adam J. Friedman MDc,d

aDepartment of Medicine (Division of Dermatology), Montefiore Medical Center, Bronx, NY
bDepartment of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY
cDepartment of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY
dDepartment of Dermatology, George Washington School of Medicine and Health Sciences, Washington, DC
*These authors contributed equally to the production of this work.

Abstract
Natural ingredients are of increasing interest within the field of dermatology. Bensal HP, an ointment containing 3% oak bark extract, 3% salicylic acid, and 6% benzoic acid, is believed to be efficacious against a variety of inflammatory and infectious dermatidites. Here we evaluate Bensal HP’s ability to influence wound healing, which has yet to be studied in this setting. Bensal HP applied to burn wounds on the dorsal surface of BALB/c mice significantly attenuated wound expansion in the first few days post-injury as compared to controls. Histological analysis mirrored these findings with accelerated maturation of the wound bed and increased collagen deposition by the end of the study period. Cytokine analysis revealed decreased IL-6 and TNFα secretion in the Bensal HP-treated burns as compared to controls. Similarly, excisional wounds treated with Bensal HP demonstrated comparable wound healing as compared to controls with positive histologic features and increased collagen deposition. Furthermore, IL-6 production was attenuated in the Bensal-HP treated wounds at day 3, with no differences appreciated in IL-6 at day 7 or in TNFα at either time point. While Bensal-HP represents a therapeutic strategy to enhance the histologic and immunologic milieu in burn and excisional wounds, further study is needed to fully elucidate the full potential of this treatment.

J Drugs Dermatol. 2015;14(11):1322-1326.

INTRODUCTION

Natural ingredients are the basis for many widely used pharmaceutical agents. Some of the most commonly used medications, including aspirin (initially extracted from the white willow tree), came about as the result of the study of plant extracts. Natural ingredients continue to be of great interest in dermatology, with new applications being developed for conditions ranging from wound infections to melanoma.1,2
Bensal HP, an ointment containing 3% oak bark extract (QRB7), 3% salicylic acid and 6% benzoic acid was developed in the 1950s by Dr. Harry Stanley as a botanical treatment. It has been used as a topical therapy for the treatment of inflammation and irritation associated with a variety of dermatidites and bacterial and fungal infections, and has been studied in the setting of diabetic foot ulcers.3 However, there is a lack of data regarding Bensal HP’s influence on general wound healing, and the mechanism by which it exerts this influence. The following study seeks to characterize the effect of Bensal HP on both burn and excisional wounds, and describes preliminary immunological data that may help to explain its mechanism.

MATERIALS AND METHODS

In-Vivo Wound Model

All animal experiments were approved by the Institutional Animal Care and Use Committee at Albert Einstein College of Medicine. The dorsal surface of 90 BALB/c mice were shaved and depilatory cream was applied and washed. Two 5mm full-thickness burns were induced on each of 45 mice by applying a calibrated 160C metal bar to the dorsal surface for 10 seconds. These were split into three groups: untreated control, silver sulfadiazine(SSD)-treated, and Bensal HP-treated. Four 5mm excision wounds were induced on the dorsal surface of the remaining mice, and these were split into three treatment groups: untreated control, petrolatum-treated, and Bensal HP-treated. Treatments (0.05cc per wound) were applied daily. Wounds were photographed daily and measured using ImageJ Software (NIH, Bethesda, MD).

Histology

Mice were sacrificed for histology on day 7 and 11 for excisional wounds, and days 7 and 17 for burn wounds. Specimens were stained with hematoxylin and eosin (H&E) and Masson’s
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