Treatment of Chronic Wounds with 10% Spruce Resin Ointment versus Silver Sulfadiazine Dressing
Tratamientos de heridas crónicas con ungüento de resina de abeto al 10% versus cura con sulfadiazina de plataMain Article Content
Introduction: Chronic wounds impose a sustained clinical burden, and local management requires alternatives supported by evidence of effectiveness and safety. Objective: To compare the evolution of linear dimensions of chronic extremity wounds treated with 10% spruce resin ointment or conventional silver sulfadiazine care. Methods: This retrospective, analytical, longitudinal cohort included 82 patients treated from August 2024 to February 2025 at a specialised clinic in Lima. Forty records documented silver sulfadiazine and 42 documented spruce resin. Maximum and minimum wound lengths were recorded at baseline and at weeks 2, 4, and 6. Results: Baseline dimensions were comparable according to the recorded analysis (p > 0.05). At week 6, mean maximum and minimum lengths were 3.43 and 2.29 mm in the resin group, compared with 30.75 and 24.75 mm in the conventional group; reported between-group comparisons were p < 0.001. No superinfection was documented in the resin group. Conclusions: Documented use of 10% spruce resin was associated with greater reduction in linear wound dimensions over six weeks. The retrospective, non-randomised design requires confirmation in controlled trials that include aetiology, wound area, complete closure, and safety outcomes.
Introducción: Las heridas crónicas imponen una carga clínica sostenida y su abordaje local requiere alternativas con evidencia de efectividad y seguridad. Objetivo: Comparar la evolución de las dimensiones lineales de heridas crónicas de extremidades tratadas con ungüento de resina de abeto al 10 % o cura convencional con sulfadiazina de plata. Métodos: Cohorte retrospectiva, analítica y longitudinal de 82 pacientes atendidos entre agosto de 2024 y febrero de 2025 en una clínica especializada de Lima. Se analizaron 40 registros con sulfadiazina de plata y 42 con resina de abeto. La longitud mayor y menor se registraron al inicio y en las semanas 2, 4 y 6. Resultados: Las dimensiones basales fueron comparables según el análisis consignado (p > 0,05). En la semana 6, las medias de longitud mayor y menor fueron 3,43 y 2,29 mm en el grupo resina, frente a 30,75 y 24,75 mm en el convencional; las comparaciones reportadas fueron p < 0,001. El registro clínico no documentó sobreinfección en el grupo resina. Conclusiones: El uso documentado de resina de abeto al 10 % se asoció con mayor reducción de las dimensiones lineales durante seis semanas. Por el diseño retrospectivo y no aleatorizado, el hallazgo requiere confirmación mediante ensayos controlados que incluyan etiología, área, cierre completo y seguridad.
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Falanga V, Isseroff RR, Soulika AM, Romanelli M, Margolis D, Kapp S, et al. Chronic wounds. Nat Rev Dis Primers. 2022;8(1):50. https://doi.org/10.1038/s41572-022-00377-3
Eriksson E, Liu PY, Schultz GS, Martins-Green MM, Tanaka R, Weir D, et al. Chronic wounds: treatment consensus. Wound Repair Regen. 2022;30(2):156-171. https://doi.org/10.1111/wrr.12994
Las Heras K, Igartua M, Santos-Vizcaino E, Hernandez RM. Chronic wounds: current status, available strategies and emerging therapeutic solutions. J Control Release. 2020;328:532-550. https://doi.org/10.1016/j.jconrel.2020.09.039
Göls T, Glasl-Tazreiter S. Fichtenbalsam (Picea abies) zur Wundheilung: eine Bestandsaufnahme. Z Phytother. 2024;45(1):4-9. https://doi.org/10.1055/a-2218-2656
Eichenauer E, Jozić M, Glasl S, Klang V. Spruce balm-based semisolid vehicles for wound healing: effect of excipients on rheological properties and ex vivo skin permeation. Pharmaceutics. 2023;15(6):1678. https://doi.org/10.3390/pharmaceutics15061678
Goels T, Eichenauer E, Tahir A, Prochaska P, Hoeller F, Heiß EH, et al. Exudates of Picea abies, Pinus nigra, and Larix decidua: chromatographic comparison and pro-migratory effects on keratinocytes in vitro. Plants (Basel). 2022;11(5):599. https://doi.org/10.3390/plants11050599
Rautio M, Sipponen A, Peltola R, Lohi J, Jokinen JJ, Papp A, et al. Antibacterial effects of home-made resin salve from Norway spruce (Picea abies). APMIS. 2007;115(4):335-340. https://doi.org/10.1111/j.1600-0463.2007.apm_548.x
Sipponen A, Jokinen JJ, Sipponen P, Papp A, Sarna S, Lohi J. Beneficial effect of resin salve in treatment of severe pressure ulcers: a prospective, randomized and controlled multicentre trial. Br J Dermatol. 2008;158(5):1055-1062. https://doi.org/10.1111/j.1365-2133.2008.08461.x
Sipponen A, Kuokkanen O, Tiihonen R, Kauppinen H, Jokinen JJ. Natural coniferous resin salve used to treat complicated surgical wounds: pilot clinical trial on healing and costs. Int J Dermatol. 2012;51(6):726-732. https://doi.org/10.1111/j.1365-4632.2011.05397.x
Dendooven E, Kerre S, Goossens A, Aerts O. Allergic contact dermatitis from a medical device containing Picea abies (Norway spruce) resin: skin sensitizers other than resin acids might be of importance. Contact Dermatitis. 2023;88(1):60-62. https://doi.org/10.1111/cod.14215
Yamileva K, Multia E. Evaluation of the irritation and sensitization potential of medical-grade Norway spruce (Picea abies) resin salve: single-blind modified Draize human repeat insult patch test in healthy volunteers. Cutan Ocul Toxicol. 2025;44(4):399-408. https://doi.org/10.1080/15569527.2025.2539501
Sánchez-Gálvez J, Martínez-Isasi S, Gómez-Salgado J, Rumbo-Prieto JM, Sobrido-Prieto M, Sánchez-Hernández M, et al. Cytotoxicity and concentration of silver ions released from dressings in the treatment of infected wounds: a systematic review. Front Public Health. 2024;12:1331753. https://doi.org/10.3389/fpubh.2024.1331753
Jiang Y, Zhang Q, Wang H, Välimäki M, Zhou Q, Dai W, et al. Effectiveness of silver and iodine dressings on wound healing: a systematic review and meta-analysis. BMJ Open. 2024;14(8):e077902. https://doi.org/10.1136/bmjopen-2023-077902
Wu JJ, Zhang F, Liu J, Yao HJ, Wang Y. Effect of silver-containing hydrofiber dressing on burn wound healing: a meta-analysis and systematic review. J Cosmet Dermatol. 2023;22(5):1685-1691. https://doi.org/10.1111/jocd.15639
Cárdenas Zuluaga C, Sepúlveda Gallego LE. Apósito de hidrofibra con plata versus sulfadiazina de plata en el tratamiento local de quemaduras de segundo grado. Arch Med (Manizales). 2023;23(1):83-91. https://doi.org/10.30554/archmed.23.1.4874.2023
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):e296. https://doi.org/10.1371/journal.pmed.0040296
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human participants. JAMA. 2025;333(1):71. https://doi.org/10.1001/jama.2024.21972