Comparison of the Effects of Contractubex® Gel in an Experimental Model of Scar Formation in Rats: An Immunohistochemical and Ultrastructural Study

January 2012 | Volume 11 | Issue 1 | Original Article | 74 | Copyright © January 2012

Mustafa T. Sahin MD,a Sevinc Inan MD,b Serap Ozturkcan MD,a Elif Guzel MDc Cemal Bilac MD,a Gülsen Giray MD,b Sevda Muftuoglu MDd

aDepartment of Dermatology, Celal Bayar University Medical Faculty, Manisa, Turkey bDepartment of Histology and Embryology, Celal Bayar University Medical Faculty, Manisa, Turkey cDepartment of Histology and Embryology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey dDepartment of Histology and Embryology, Hacettepe University Medical Faculty, Ankara, Turkey

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fibronectin, it can influence cell adhesion, growth, morphology, differentiation, migration, and agglutination as well as the assembly of the extracellular matrix. Because most differentiated cells are difficult to maintain in culture, laminin may be an important supplement in studies on cell differentiation in vitro.23
There are numerous clinical studies, in which the efficacy and the tolerability of extractum cepae-heparin sodium-allantoin mixture have been conducted.5,8,24 A reduction in both inflammation, fibroblast proliferation, and connective-tissue components such as collagen, can explain the effects of extractum cepae-heparin sodium-allantoin mixture, not only have anti-inflammatory effects, but they also exert similar antiproliferative effects that, in the case of excessive scar formation in hypertrophic and keloidal scars, depress fibroblast proliferation and reduce scar size. Its depressing effect on collagen structure may promote physiologic scar development.5 In in-vitro studies to show the exact mechanism of action of extractum cepae-heparin sodium-allantoin mixture, onion extract reduced the proliferative activity and the production of substances in the extracellular matrix. Heparin can interact strongly with collagen molecules, and induces the formation of thicker fibrils, typical for a mature tissue, and promotes intermolecular bonding in collagen.24These two active ingredients of extractum cepae-heparin sodium-allantoin mixture, therefore, affect scar development by the inhibitory effects on inflammatory processes, fibroblast proliferation, and the synthesizing capacity of fibroblasts.4,24 In a later stage, which is further characterized by connective tissue fibers, a loosening effect on collagen structure is achieved by the combination of onion extract, heparin, and allantoin. The polyelectrolytes heparin and allantoin have a hydrating effect, which, in addition, promotes the softening of the indurated scar structures.8