Effect Phenytoin Therapy to Fibroblasts and Angiogenesis of Enterocutaneous Fistula in Wistar Rat

Abstract

Background: Comprehensive wound care in enterocutaneous fistula (ECF) is the therapeutic of choice
currently, which may increase of closure rate without surgery from 19 to 92%. Phenytoin has been reported
have anticolagenase effect on wound healing is hoped to improve the ECF closure.
Aim: The study was aimed to demonstrate the effect of phenytoin on closure of enterocutaneous fistula seen
from the number of fibroblasts and angiogenesis
Methods: This study was “Randomized Controlled trial with post test only group design” on 18 male
wistar rats with ECF, that were divided randomly into three groups: group(K) control, P1(topical phenytoin),
P2(oral phenytoin). After 7 days of treatment, they were terminated and histopathological examinations were
performed to do fibroblast cell counting and the amount of angiogenesis by Hematoxilin Eosin staining.
Results: Mean of the number of fibroblastin groups K, P1 and P2 were 69.50 ± 10.07, 155.50 ± 13.50 and
182.16 ± 11.85 respectively (One way Anova P=0.001) and mean of the number of angiogenesis in groups
K, P1, and P2 were 95.66 ± 9.72, 178.66 ± 11.75, and 205,16 ± 9.74 respectively (One way Anova P=0.001).
Post Hoc Test LSD showed thatthe number of fibroblast of group P1 vs K(P=0.001), P2 vs K(P=0.001),
P1 vs P2(P=0.004) and the number of angiogenesis of group P1 vs K(P=0.001), P2 vs K(P=0.001), P2 vs
P1(P=0.002).
Conclusion: The therapy of topical and oral phenytoin increased the number of fibroblasts and angiogenesis
in Wistar rat with ECF. Out come of oral phenytoin therapy better than topical.