Background: Transdermal drug delivery has several advantages and has been vastly investigated over the last decades. Chemical enhancers improve the quantity of drug penetration through the skin.Objectives: In this study, some conventional solvents and surfactants were used as enhancers to promote dermal penetration of a-hydroxyacids (AHA) and hyaluronic acid (HA).Materials and Methods: A total of 42 different formulations containing AHA or HA as the active ingredient and a solvent or surfactant as the enhancer were prepared. The experiments for determination of transdermal absorption of AHA or HA for each formulation were performed using a diffusion cell and a slice of chicken skin as model at 32oC. After 1.5 or 12 hours, samples from the medium were collected and analyzed for AHA or HA concentration.Results: After 1.5 and 12 hours, the maximum permeated amount of AHA were 89.8 and 342.5 mg, respectively, which related to the formulations with liquid paraffin. After 1.5 and 12 hours, the maximum permeated amount of HA were 57.3 and 70.6 mg, respectively, which related to the formulations with glycerol.Conclusions: The most effective enhancer for AHA and HA were liquid paraffin and glycerol, respectively. The most effective surfactant for both AHA and HA was Tween 80. The effects of the enhancers were increased by prolonging the exposure time.

The potential for many of the commonly used surgical site wound adhesives, skin antiseptic solutions, TOPICAL antibiotics, and suture materials to sensitize and subsequently result in allergic contact dermatitis (ACD) has become increasingly recognized within orthopedic surgery. Particularly with subsequent exposure to the offending allergen, the cutaneous allergic reaction may present in a similar fashion to cellulitis, thus making early differentiation between the two etiologies to initiate the appropriate and timely treatment crucial. Recognition of the characteristic appearance and severity of ACD surrounding a surgical wound often drives the initial management. This typically consists of anti-histamines, TOPICAL corticosteroids, and possible removal of the offending allergen for low grade findings and oral steroids and prophylactic oral antibiotics for the more severe reactions. Multidisciplinary care, including the expertise of a dermatologist or wound care specialist when faced with this challenging clinical scenario is critical and elective patch testing may be indicated to ascertain the exact allergen involved, particularly in patients with a prior history of wound issues. Finally, any clinical cases of ACD following an orthopedic procedure should be documented in the patient’s chart so that exposure can be avoided with any future surgery. Level of evidence: III

Background: One of the preservative treatments of knee osteoarthritis is the use of TOPICAL medications. This study is aimed to clinically evaluate the effect of TOPICAL PRODUCTS containing essential oils of rosemary and lavender herbs on the treatment of patients with osteoarthritis of the knee.Materials and Methods: Rosemary and lavender essential oils were prepared by steam distillation method and inserted into the ointment with the hydrophilic base. In this study, 15 patients with knee osteoarthritis were treated with this ointment for three months. The results were assessed using WOMAC and Lequesne indices and were evaluated by the Wilcoxon statistical test.Results: At the week of admission to the hospital, mean WOMAC index was equal to 71.4, mean Lequesne index was equal to 18 and the average time of passing through the distance of fifty feet by patients was equal to 19.4. After 4, 8 and 12 weeks, all these indices significantly decreased (p£0.05). The WOMAC questionnaire denotative survey also showed that the pain and physical function at the 4th, 8th and 12th weeks were significantly less than the first week of admission (p£0.05), but there was no significant difference as far as joint stiffness is concerned.Conclusion: TOPICAL application of essential oils of rosemary and lavender herbs in a hydrophilic ointment base can be useful as a preservative treatment for the patients with knee osteoarthritis.

TOPICAL corticosteroids are commonly used for decreasing inflammation after strabismus surgery. However the use of TOPICAL corticosteroids may be associated with several adverse effects. The aim of this study was to compare the relative effects of TOPICAL diclofenac with betamethasone in inflammation, wound healing and intraocular pressure following strabismus surgery. A single centre, single observer, prospective, randomized and single blind clinical trial of 43 patients undergoing strabismus surgery was carried out. Both postoperative treatments were instilled four times per day in the first week and two times per day in the second week postoperatively. Patient pain and discomfort, conjunctival chemosis, injection, conjunctival gap, and intraocular pressure were assessed at one day, one week, two weeks and four weeks after surgery. Since the first postoperative week the diclofenac group showed less discomfort and less conjunctival inflammation, edema, and conjunctival gap than the betamethasone group and these differences became statistically significant at the second week after surgery. There was not any significant difference between mean intraocular pressure of the diclofenac and the betamethasone group in any postoperative measurements. Diclofenac appears to be superior to corticosteroids in controlling the inflammatory responses and surgical wound healing after strabismus surgery. The maximal effect of diclofenac occurred at 2 weeks after surgery.