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.