Optimizing Skin Wound Healing Outcomes: A Comparative Analysis of Cytokine Response and Tissue Remodeling at treatment with Poysilicone-siloxane, Silicone, Betamethasone and Heparin-based preparations

Abstract

Skin wound healing is a complex, dynamic process crucial for preserving bodily integrity, encompassing stages of hemostasis, inflammation, proliferation, and remodeling, involving cytokines like IL-1 and IL-6, fibroblasts, collagen, and elastic fibers. This study evaluates the effects of various treatments (poysilicone-siloxane based (PS), silicone (Sil), betamethasone (BMt) and heparin-based (Hep) preparations) on cytokine levels and histological markers during wound healing in laboratory rats with full-thickness skin wounds. PS, Hep and Sil creams were applied 2-3 times daily, and BMt was administered subcutaneously weekly. The changes in scar appearance during healing and treatment were assessed using the Vancouver Scar Scale (VSS). ELISA was used to assess IL-1 and IL-6 levels, while histological markers were evaluated via immunohistochemistry, Masson’s trichrome, Van Gieson, Weigert’s, and H&E staining. Results demonstrated that IL-1 levels significantly increased by day 7 in all groups, but only normalized by day 21 in PS and Sil-treated animals, while BMt-treated animals required until day 28. Control and Hep-treated groups showed persistent IL-1 elevation beyond day 28. Similarly, IL-6 levels rose on day 14, normalizing by day 28 in PS, Sil and BMt-treated groups, yet remaining elevated in Hep-treated and control groups. Histological analysis revealed that vascularization normalized by day 14 in PS-treated animals, by day 21 in Sil-treated animals, and persisted until day 28 in BMt and Hep-treated groups. Collagen deposition and elastic fiber normalization occurred earliest in PS-treated animals, followed by Sil and BMt, while Hep-treated animals exhibited delayed collagen deposition only by day 28. PS was the most effective treatment for promoting optimal scar characteristics, including reduced vascularity, proper pigmentation, pliability, and scar flattening. Sil and BMt groups showed moderate improvements in wound healing and scar characteristics, while Hep was less effective in accelerating wound healing and scar normalization. Conclusion: The findings highlight IL-1 and IL-6 as pivotal inflammatory mediators in wound healing and suggest that PS, Sil, and BMt effectively modulate cytokine responses and promote vascularization, collagen, and elastic fiber normalization. PS group exhibited the most rapid wound healing response, followed by Sil and BMt, while Hep had limited efficacy. These results underscore the importance of targeted therapeutic interventions in wound management and offer potential for optimizing treatment strategies for improved healing outcomes. Further research is warranted to elucidate precise mechanisms and to explore additional biomarkers associated with tissue repair and inflammation resolution.