Introduction
Oral surgical wounds have obvious pain characteristics and prolonged healing resulting from multiple factors such as bare mucosa left for secondary healing, rich innervated sensory nerve fibers, and inevitable exposure to mechanical and chemical irritation.
There have been many attempts to invent novel cytoprotective agents and dressings for intraoral open surgical wounds, however, only few have reached clinical trials and come at very high costs. Use of topical analgesics including NSAIDs, corticosteroid and lidocaine can relieve postoperative pain however they must be used with caution for systemic adverse effects and unclarified risk of wound complications such as prolonged wound healing and postoperative bleeding.
Sucralfate is an effective cytoprotective agent that has long been used to treat peptic ulcers. It is also proven to be clinically effective in both pain relief and healing promotion in other mucosal ulcers such as post tonsillectomy wound [1], post uvulopalatoplasty wound [2], aphthous ulcer[3], chemoradiation mucositis and proctitis[4], chronic venous ulcer[5]. Cytoprotective property of Sucralfate results from direct contact of Sucralfate with exudative matrix protein released from injured cells to form a physical barrier that coats over wound bed epithelium, thereby, preventing it from exposure to the external environment, protecting from physical shearing force while reducing irritation of cut free nerve endings and muscles. Sucralfate also induces PGE-2 and fibroblast GF mucosal concentration by unknown mechanism which also helps in facilitating the reepithelialization process.
In this clinical trial, we introduce the use of Sucralfate as an oral rinse in postoperative intraoral open wound. This is the first study to assess drug effectiveness in terms of both pain reduction and wound healing promotion.