The Differences of using Povidone Iodine 10% ointment and Turmeric (Curcuma

domestica) Extract Ointment on the Number of Fibroblast on Incised Wound

Healing Process in White Male Rats (Rattus norvegicus strain wistar)
Safira Putri Herdiana

Fakultas KedokteranUniversitas Muhammadiyah Malang

Jl. Bendungan Sutami No. 188A, Malang

E-mail : Putrisafira98@gmail.com

ABSTRAK

Latar Belakang : Perawatan luka yang baik diperlukan dalam proses penyembuhan luka. Salah satu metodenya
adalah pemberian obat topikal. Povidone iodine 10% mengandung antiseptik yang sering digunakan sebagai
pengobatan luka. Kunyit (Curcuma domestica) dapat digunakan untuk perawatan luka alternatif karena
mengandung komponen bioaktif seperti saponin, tanin dan terpenoid yang berperan dalam proses penyembuhan
luka sebagai antiinflamasi, antibakteri dan dapat meningkatkan sintesis kolagen.Tujuan : Membandingkan
efektivitas salep ekstrak kunyit dengan salep povidone iodine 10% terhadap jumlah fibroblast dalam proses
penyembuhan luka sayat tikus jantan putih (Rattus norvergicus ketegangan wistar). Metode : True Experimental,
Post Test Only Control Group Design. Sampel dibagi 3 kelompok. Kelompok 1 kontrol positif (transparent
dressing), kelompok 2 (aplikasi salep povidone iodine 10%), kelompok 3 (aplikasi salep ekstrak kunyit). Hewan
uji diberi perlukaan sayatan pada punggung, dengan ukuran ± 2 cm. Pengambilan sampel jaringan kulit dilakukan
setelah 14 hari. Untuk melihat jumlah fibroblast dilakukan pembuatan preparat dengan pengecatan Hematoxylin
Eosin. Hasil Penelitian dan Diskusi : Uji normalitas menunjukkan bahwa distribusi data normal dengan p>0.05.
Uji homogenitas menunjukkan sig=0,065 yang berarti varian data fibroblast hewan coba homogen. Hasil uji one
way anova menunjukkan signifikansi p=0,000 yaitu terdapat perbedaan bermakna jumlah fibroblast antara
kelompok kontrol dengan kelompok perlakuan. Kesimpulan : Salep ekstrak kunyit menunjukkan peningkatan
jumlah fibroblast pada proses penyembuhan luka dibandingkan dengan salep povidone iodine 10%

Kata Kunci : Fibroblast, salep ekstrak kunyit, salep povidone iodine 10%.

ABSTRACT

Background: Adequate woundxcare is needed onxwound-healing process. Applying topical agent is one of the
wound care methods. Povidonexiodine 10% containxantiseptic is often use as treatment of wound.
Turmericx(Curcumaxdomestica) can be used to alternative wound care because it containsxbioactive components
such as kurkumin, saponin, tanin, and terpenoid that play a role in woundxhealing as antixinflammation, anti
bacterialxagent and promotexsynthesis collagen. Objective: To compare thexeffectivity of turmeric
extractxointment with povidone iodinex10% ointment on the number ofxfibroblast in healing process of
incisedxwound in white male wistar rats (Rattusxnorvergicusxstrain wistar). Methods: True experimental and
post-test only a control group design were used. The sample was divided into 3 groups. The positive control group
were used Transparant dressing, the treatment groups were used povidone iodine 10 % ointment and extracts of
turmeric (Curcuma domestica) ointments 0,5g, twice a day for 14 days. Research Result and Discussion:
Normality test showed that the distribution of data were normal with p>0.05. Homogenity test showed sig=0,065
which mean variant of fibroblast data of animal experiment are homogenous. One Way Anova test result showed
sig p=0,000 which mean significant of fibroblast content between control group and treatment group.The
conclusion: Turmeric extract ointment showed an increase in the amount of fibroblast were greater in the process
of wound healing compared with povidone iodine 10% ointment.

Keywords: Fibroblast, turmeric extract ointment, povidone iodine 10% ointment

1
INTRODUCTION
Wound is lost or damage to most tissues
of the body. This situation can be caused by
sharp objects or blunt trauma, temperature
changes, chemical substances, explosion,
electric shock, or animal bites (Hasibuan,
Soedjana & Bisono, 2010). The process
after the wound is the process of wound
healing. Wound healing is the process of
repair and replacement of damaged tissue
function (Kartika, 2015).
The prevalence of injuries in the rest of
the world is operating i.e. wounds 110
million cases per year while the injuries due
to trauma 1.6 million cases per year, burns
1.25 million people, chronic wounds of 6.5
million people, injuries due to traffic
accidents (KLL) 1.02%, and cuts due to the
non-KLL 0.4% (Indonesia health profile,
2014). Incision is wound injuries most often
occurred in Indonesia, based on
RIKESDAS year 2013 mentioned that
figure Gen. Incision is a sequence of three
types of injuries most IE as much as 23.2%
(Health, 2013).
Traditional crops have the potential as a
wound healing agent and most favored
community because of the availability of
space. Turmeric plants have ample
adaptation power in the Tropics (Priyono,
2010). Indonesia community usually use
turmeric plants to be made into a powder
drink/herbs, body scrub (cosmetics), pill
(medicine), and others (Priyono, 2010).
Turmeric can be potentially as drugs wound
because turmeric contain flavonoids,
saponins, tannins, and triterpenoid
(Partomuan Simanjuntak, 2012). Chemical
studies on some simplisia turmeric showed
that chemical composition in the turmeric
plant is essential oil 4.2 – 14%, oil fats 4,4-
12.7%, and compounds kurkuminoid 60-
70% (Partomuan Simanjuntak, 2012). On
2
the research that has been done by the Ardri
Nugraha dkk (2015) mention that turmeric
Curcumin levels had a lot more compared
to other plants by temulawak, Curcumin
levels found in turmeric is in the range of ±
3.03 0.01-0.02 ± 7.31 and at temulawak in
the range of 0.02 ± 1.69-4.92 ± 0.01.
Ethanol extracts of turmeric has the
potential for bitter taste. It is thought to be
the effects of Curcumin as one of the active
ingredients that can inhibit the formation of
turmeric prostaglandins and suppress the
activities of the enzyme siklooksigenase
(SN, Khotimah & Muhtadi A, 2014). In
addition the turmeric is also useful as an anti
oxidant, anti microbial, anti cancer, tumor
suppression, and lowered levels of blood fat
and cholesterol, as well as a blood purifier
(Puji Lestari, 2016).
This research aims to know the effects of
turmeric extract ointment against the
process of wound healing white wistar rats
sayat (Rattus Norvegicus) and assess its
potential when compared to povidone
iodine. In this study will observe the
number of fibroblasts, fibroblastic cells
where it is used as an indicator of wound
healing because of this cell is a cell that is
dominant in the process of wound healing.
RESEARCH METHODS
Research done by using this method The
post test only control group design with a
large sample of 27 mice tails. Test animals
used white mice (Rattus norvegicus) is
strains wistar males aged 2-3 months,
weight 150-200 g, the body of a rat in a
State of healthy marked with active
movement, thick fur, and eyes that waters.
Research done in the laboratory
biomedicine FK UMM. This research was
done for 21 days.
Stages Of Manufacture Of Turmeric
Extract
Turmeric Rhizome sliced thin after that
dried with a temperature of 40oC hour into
simplisia dry. Methods of maceration with
solvent ethanol 96% added in comparison
with dried 10:1 simplisia and soaked for 24
hours. After that the filtrate is
accommodated and evaporating, so that
produce ethanol extracts of semi solid.
Ethanol extracts of semi solid is inserted
into a separating funnel dalami kemudiani
added ihexan and dihomogenisasikan
solution for 15 imenit. Hexan fraction
separated from ethanol and is evaporated
with the rotary evaporator, so obtained
fraction hexan.
Stages Of The Making Of Ointments
Solution of ethyl acetate ethanol extract
is then added on with 1:1 dalami
comparison of the separating funnel.
Further shaken for 15 minutes and only
needs to formed a double layer of solvent.
The top layer is ethyl acetate, while the
Undercoat is ethanol.
Ethyl acetate fraction is separated and
then is evaporated, thus obtained fraction of
ethyl acetate. The fraction of ethyl acetate
and fraction of ethanol extracts of turmeric
Rhizome hexan is presented in the form of
pharmaceutical preparations ointment. The
fraction of ethyl acetate and hexan each
with a concentration of 10% dihomogenisa
with yellow Vaseline using mortar. After it
is stored in a tube and is labeled (Winarsih
et al, 2012).
Identification number of fibroblasts cells
The process of identification of
fibroblasts effected after wound care is
3
completed. Fibroblasts are the cells in the
form of oval, have one or more nuclei, are
basofilik, and purple on coloring tercat
hematoxylin eosin was performed at the
time of the observation preparations
histology of skin tissue using olympus
microscope with magnification of 400
times, as well as calculations done with
roomy 4 different points of view and then
calculated how much each airy fibroblasts
of view, from the point of view of airy
spacious 1 to 4 point of view combined and
taken its average.
Stage Of Treatment
Rats were divided into 3 groups,
namely:
a. positive control group (K +): Given the
wound incision on the backs of mice
along the 2 cm to a depth of
subcutaneous then covered with
Transparent Dressings are observed
daily for 14 days.
b. treatment Group 1 (P1): Given the
wound incision on the backs of mice
along the 2 cm to a depth of
subcutaneous Povidone iodine ointment
then given 10% 2 times/day is observed
every day for 14 days.
c. Treatment Group 2 (P2): Given the
wound incision on the backs of mice
along the 2 cm to a depth of
subcutaneous Povidone iodine ointment
then given 10% 2 times/day is observed
every day for 14 days.
RESEARCH RESULTS
Based on the results in the data table 1
treatment group using povidone iodine
ointment 10% average number of
fibroblasts cells as much as 2.531. Group
treatment using turmeric extract ointment
10% average number of fibroblasts cells as Average number of
Group
much as 4.375. Positive control group fibroblasts cells
treatment groups are only given the P1 2,531
transparent dressing average number of P2 4,375
fibroblasts cells as much as 1.812. K+ 1,812
Based on the results of observation of the Description:
number of fibroblasts cells over look that
the group uses of turmeric extract ointment P1: using Povidone iodine ointment
10% most effectively increase the number Treatment 10%
of fibroblasts cells on wound healing P2: Treatment using turmeric extract
process of incision than other groups. ointment 10%
K +: control group by using the transparent
dressing

The description of the white rat fibroblasts cells histopathology male each treatment with
400x magnification. A: the control group, B: 1, C Treatment: the treatment 2

Based on the test results using the Shapiro- homogeneous because p > 0.05. It can be
wilk normality. On this penilitian normal concluded that the distribution of the data is
distribution of data obtained, viewed from the both normal and homogenized so that data
sig p > (0.05). Test results of its homogeneity analysis followed by one way anova test.
using Levene test shows sig = 0.065 One way anova test results showed
meaning Variant data the number of significance p = 0.000 that shows there is a
fibroblasts cells of animals try meaningful difference between fibroblasts
4
cell number control group with treatment.
Because of the One Way Anova test is
meaningful and homogeneous data variants,
then followed by Bonferroni Post Hoc test
to find out which groups have a meaningful
difference.
Hoc Bonferroni Post test, note that
comparisons of the number of fibroblasts in
the control group differed significantly
(meaningful) and the group that was given
a povidone iodine ointment (sig = 0.002)
and the group who were given turmeric
extract ointment (sig = 0.000). The group
that was given a turmeric extract ointment
has the most significant results than the
treatment group was given a povidone
iodine ointment 10%.
DISCUSSION
Based on the results of the measurement
of the average number of fibroblasts cells of
the mice given turmeric extract ointment
more compared to povidone ointment
provided group iodine 10%. It can be seen
from the description of the histologic cell
fibroblasts that can serve as an indicator of
wound healing. The results of the analysis
of the data shows that there is a meaningful
difference between groups 1 (control group)
and group 2 (apilkasi povidone iodine
ointment 10%) and group 3 (application of
turmeric extract ointment).
An increasing number of fibroblasts is
suspected due to the effects of active
compounds derived from extracts of
turmeric. The results of the ethanol
extraction of turmeric contain several active
compounds namely Curcumin, saponins,
tannins, and essential oils. The content can
help the healing process of wounds by
different mechanisms (Arum DS, Retty R,
& Heri K, 2015).
5
Curcumin has biological activity quite
extensive including antioxidant,
antibacterial and speed healing by means of
increasing the production of TGF β-1 in the
process of wound healing. TGF-β 1 can
spur the proliferation of fibroblasts also
participate in the synthesis of collagen (A &
Chatarina LS Setyowati, 2013).
Saponin is a steroid or triterpenoid
glycosides and many found on the plants
plays an important role on the health of
humans and animals. Saponins serves as
antitumor, cytotoxic activity and
antimutagen. Saponins VEGF can trigger
and increase the number of macrophages
migrate into the wound area thus increasing
cytokine production that will enable
fibroblasts in wound tissue. Saponins can
potentially help heal wounds by forming
collagen is the first who had a role in the
process of wound healing (Aliefia, Umi K,
DK & Ika SR, 2015).
Tannin is a water soluble phenolic
compounds. Tannins are potentially as
antoksidan that protect from oxidative
damage such as cancer, arthritis and aging.
The content of tannin can stop the bleeding,
accelerates wound healing and
inflammation mucous membranes, as well
as the regeneration of new tissue. In
addition, the content of tannin has the
ability of antioxidant and antibacterial. The
content of tannins speed healing of wounds
with some cellular mechanism that is
cleaning up free radicals and reactive
oxygen, increasing closure of the wound as
well as increasing the formation of
capillaries also fibroblasts (Christina D, S,
Ketut & Jusak N, 2017).
Essential oil or also called the essential
oil derived from leaves, flowers, wood,
grains even the stigma of flowers. The
benefits of essential oils is as anti pain, anti-
infective and killer bacteria (disinfectant).
Essential oil contains phenols and kavikol
are useful as antimicrobial, antibacterial
and disinfectant. All content of the turmeric
extracts can clean wounds and prevent the
occurrence of infection so that it can
accelerate the end of inflammatory phase of
wound healing process (Aliefia, Umi K, DK
& Ika SR, 2015).
Based on the discussion above, then the
hypothesis in this study have been missed,
namely the granting of turmeric extract
ointment more influence on increasing the
number of fibroblasts cells on wound
healing process of white rat males sayat
(rattus norvegicus wistar strain) as
compared to the granting of
povidonexiodine ointment 10%.
CONCLUSION
There is a difference of influence use of
povidone iodine ointment 10% of turmeric
extract ointment and against the number of
fibroblasts in wound healing process sayat
rats wistar white.
Results the average number of
fibroblasts in the group that was given a
turmeric extract ointment more than in the
group that was given a povidone iodine
ointment 10%, i.e. a group of turmeric
extract ointment average number of
fibroblasts obtained is as much a 4.375 , and
the average number of fibroblasts in the
group that was given a povidone iodine
ointment 10% as much as 2.531.
ADVICE
1. the test has to be done on the physical
stability of turmeric extract ointment
preparations further enhanced earlier
test method and evaluation of its
homogeneity and pH.
6
2. toxicity tests need to be done towards
turmeric extract ointment preparations
to know a safe concentration limit used.
3. further research needs to be done with
the concentration of extract more varied
to find out the optimal concentration for
accelerating wound healing.
4. closing the wound needs to be done on
all the research groups to prevent the
onset of infection.
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