BACKGROUND/AIM: The wound-healing effect of lipopolysaccharide (LPS) reportedly results from its ability to induce the removal of foreign bodies, anti-inflammatory function, and tissue-repair function. We reported the improvement of patients with protracted wound healing after the dermal administration of topical cream containing LPS derived from Pantoea agglomerans, which is a symbiotic bacterium present in wheat and confirmed as safe.PATIENTS AND METHODS: Topical cream with LPS was applied on four patients who showed protracted wound healing, after their informed consent. The wound was evaluated on the basis of the change in the approximate wound volume calculated from the width, length, and depth of the wound.RESULTS: Case 1: A 76-year-old man developed infection at the puncture site after endovascular laser treatment of the right lower extremity varicose veins and suffered protracted wound healing. The wound was treated with gentamicin application containing LPS, and shrank in two weeks. Case 2: A 72-year-old man developed a wound infection and had purulent drainage one week after endovascular laser treatment of the left lower extremity varicose veins. The wound was closed in one month using gentamicin application containing LPS. Case 3: A 67-year-old woman with protracted wound healing developed infection in the right inguinal region after the surgical treatment of acute aortic dissection and experienced complete wound dehiscence. The wound shrank one week after gauze packing with LPS and was temporarily sutured. The wound was completely closed in two weeks with gentamicin application containing LPS. Case 4: An 86-year-old woman with protracted wound healing became bedridden after cerebral infarction and developed pressure ulcers in the sacral area. The ulcer disappeared in four months with LPS-containing sugar and povidone-iodine application twice a day. There were no adverse effects from LPS application in any of these patients.CONCLUSION: In diabetes, one cause of protracted wound healing is the low innate immune function, such as the phagocytic activity of macrophages. LPS is expected to promote healing by improving innate immunity, and its beneficial effect of promoting wound healing was clearly demonstrated in the present cases. The topical application of LPS is clinically effective for wound healing and is considered a potentially novel treatment method.
Administration, Topical Aged