Perbaikan Histopatologi Luka Tajam setelah Pemberian Ekstrak Alkohol Bahan Alam yang Mengandung Flavonoid Secara Topikal: Tinjauan Sistematis dan Meta-Analisis

Abstract

Introduction: A wound is a disruption of the cellular, anatomical and functional continuity of a tissue caused by sharp or blunt trauma and others. Flavonoids which have anti-inflammatory, antibacterial and antioxidant properties have the potential to be wound healing agents. But, no systematic review and meta-analysis exists for evidence-based medicine. Objective: To determine the effect of topical administration of alcohol extracts of natural ingredients containing flavonoids in improving histopathology, epithelialization period and contraction of sharp wounds. Method: Systematic review and Meta-analysis based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Studies were searched through four databases. Studies were selected based on eligibility criteria and quality assessment using Systematic Review Centre for Laboratory animal Effect size use Mean Difference (MD) with 95% Confidence Interval (CI). Random or fixed effect models were used based on the level of heterogeneity, and were considered significant if the p value is <0.05. Result: Researchers obtained 569 studies which were selected into 6 studies. Five of the six studies concluded that flavonoid significantly improve the histopathology of wounds. In the meta-analysis, the the epithelization period is significantly faster (MD= -3,63, 95% CI [-4,32; -2,95], p<0,00001, I2= 73%). The percentage of wound contraction was also significantly greater on days 3 (MD= 2,37, 95% CI [1,48; 3,26], p<0,00001, I2= 10%), 6 (MD= 11.11, 95% CI [8,01; 14,22], p<0,00001, I2= 88%), 9 (MD= 19,12, 95% CI [12,72; 25,52], p<0,00001, I2= 97%), 12 (MD= 15,99, 95% CI [9,60; 22,39], p<0,00001, I2= 99%), 15 (MD= 12,15, 95% CI [6,47; 17,82], p<0,0001, I2= 0%), 18 (MD= 13,13, 95% CI [4,70; 21,56], p= 0,002, I2= 100%). Conclusion: The administration of alcohol extracts of natural ingredients containing flavonoids has been proven to improve the histopathology of sharp wounds, increase the epithelization period and wound contraction.