burnt wound is an injury , especially burned by fire , heat , caustic agents , electricity or radiation ( 1 ) . it can be classified into epidermal , partial thickness and full thickness burn wound ( 2 ) . incidence rate of burn injuries is approximately 1.25 million cases per year in the united states ( 3 ) . the prevalence of burning in third world countries is several times more than europe and north america in which are also more severe ( 4 ) . infection due to new strains of drug resistant bacteria is the major impediment topical factor in healing process and also prolongs treatment period ( 5 , 6 ) . improving the methods of wound healing , tissue repairing and decreasing the time of hospitalization offer tremendous opportunities to enhance the quality of life for burnt patients ( 7 ) . silver sulfadiazine ( ssd ) was introduced in 1970s as an antibacterial agent for topical treatment of burns and wounds ( 8) . ssd cream , although being effective , causes some systemic complications including neutropenia , erythema multiform , crystalluria and methemoglobinemia ( 9 ) . although ssd has been the standard treatment of burn wound in hospital , alternative treatment for burnt wound that is cheaper and locally available is still needed ( 10 ) . visceral fat of goat mixed with barley seed ash ( vf - bs ) has been used in iranian traditional medicine in the treatment of wounds and burns . traditional use of this natural product is recommended in some region of fars province , southern iran . barley ( hordeum vulgare l ) belongs to the grass family , poaceae ( gramineae ) . barley grain is an excellent source of dietary fibers and other bioactive constituents , such as protein and complex carbohydrates and a good source of certain vitamins and minerals . furthermore , barley contains many other compounds including simple phenolic acids , flavonoids and lignans , all of which have good antioxidant properties ( 12 , 13 ) . visceral fat tissue refers to the ectopic fat depots surrounding the internal organs and is often used synonymously for intra - abdominal fat ( 14 ) . in general , visceral fat depots in goats consist mainly of saturated fatty acid ( sfa ) , monounsaturated fatty acid ( mufa ) and small amounts of polyunsaturated fatty acid ( pufa ) ( 15 ) . today , there is growing interest towards clinical application of natural drugs in healing of burn wounds ; therefore , the present study was designed to compare the healing effects of traditional preparation with ssd on type ii superficial skin burning in rats . visceral fat prepared from fat around the intestine of goats was obtained from slaughterhouses in shiraz . six - rowed barley grains ( hordeum vulgare.l ) were collected from nourabad mamasani region in northwest of fars province , iran . the grains were identified at the herbarium of department of pharmacognosy , school of pharmacy , shiraz . the barley grains were burned by indirect heat , at 160c for 30 minutes and then were powdered . then burnt powder and oil was mixed in proportion of 1 to 2 respectively , and it was shaken to produce a uniform suspension . finally , this cream was sterilized . 60 male albino wister rats with mean body weight of 250 - 300 g and 5 - 6 months old were obtained from the laboratory animal breeding and maintenance center of grash medical faculty , iran . they were kept in polycarbonate cages under standard condition ( temperature 24 - 28c , relative humidity 60 - 70% and 12-hour dark - light cycle ) and fed with standard pelleted diet and water ad libitum . all experimental protocols involving animals were reviewed and approved by the local animal ethics committee guideline for use of experimental animals . the back of rats was shaved with a sterilized razor blade . following this procedure , the animals were returned to their cages for 24 hours to reduce swelling caused by shaving . a method described by kaufman et al . the rats were initially anesthetized with single intramuscular injections of 6 mg / kg xylazine hydrochloride ( rompun , bayer , 23.32 mg / ml ) and 85 mg / kg ketamine hydrochloride ( ketalar , parke - davis , 50 mg / ml ) . the skin of animals back prepared with 10% antiseptic povidone - iodine solution ( kim - pa , poviiodeks , 10% povidone - iodine ) . then second - degree burn was created by a metal cylinder ( 1.5 cm i d , self - made ) immersed in boiling ( 100c ) water for three minutes and maintained on the back of rats for three seconds . all animals were resuscitated immediately with lactate ringer s solution ( 2 ml/100 g of body weight ) intraperitoneally . finally , each animal was placed in a separate cage . to avoid variations between experiments , normal saline group : immediately after burning , normal saline was applied topically onto the surface of burn areas , twice a day for 14 consecutive days . silversulfadiazine group : immediately after burning , ssd cream was applied topically onto the surface of burn areas , twice a day for 14 consecutive days . traditional preparation group : immediately after burning , traditional preparation was applied topically onto the surface of burn areas , twice a day for 14 consecutive days . the burn wound site was photographed with a digital camera ( sony cybershot dsc - p72 ) on days 1 , 4 , 9 and 14 . based on images obtained from the digital camera , the wound area was measured with image processing software ( digimizer 4.1.1.0 , persiangfx.com ) . the evaluated surface area was then used to calculate the percentage of wound contraction , tacking the initial size ( measured on day one ) of the wound as 100% using the following formula ( 17 ) . for microscopic studies , five rats from each group were killed on 4th , 9th and 14th days of experiment , and then burned area with a little normal skin was sampled . these tissue samples were kept in 10% neutral buffered formalin solution and sent to pathologic laboratory of veterinary medicine , shiraz university of medical sciences . after fixation in formalin solution , the skin tissues were embedded in paraffin , cut into 5 m sections , stained with hematoxylin and eosin dye . stained slides were observed for re - epithelization , collagen content , inflammatory changes , polymorphonuclear cells , vacuolization and fibroblast . the percentage of wound contraction was analyzed by statistical package spss 18.0 for windows ( ibm company ) . differences between groups in different days were estimated using one - way anova analysis of variance . visceral fat prepared from fat around the intestine of goats was obtained from slaughterhouses in shiraz . six - rowed barley grains ( hordeum vulgare.l ) were collected from nourabad mamasani region in northwest of fars province , iran . the grains were identified at the herbarium of department of pharmacognosy , school of pharmacy , shiraz . the barley grains were burned by indirect heat , at 160c for 30 minutes and then were powdered . visceral fat of goat was heated very slowly by indirect heat to be melted . then burnt powder and oil was mixed in proportion of 1 to 2 respectively , and it was shaken to produce a uniform suspension . 60 male albino wister rats with mean body weight of 250 - 300 g and 5 - 6 months old were obtained from the laboratory animal breeding and maintenance center of grash medical faculty , iran . they were kept in polycarbonate cages under standard condition ( temperature 24 - 28c , relative humidity 60 - 70% and 12-hour dark - light cycle ) and fed with standard pelleted diet and water ad libitum . all experimental protocols involving animals were reviewed and approved by the local animal ethics committee guideline for use of experimental animals . the back of rats was shaved with a sterilized razor blade . following this procedure , the animals were returned to their cages for 24 hours to reduce swelling caused by shaving . a method described by kaufman et al . the rats were initially anesthetized with single intramuscular injections of 6 mg / kg xylazine hydrochloride ( rompun , bayer , 23.32 mg / ml ) and 85 mg / kg ketamine hydrochloride ( ketalar , parke - davis , 50 mg / ml ) . the skin of animals back prepared with 10% antiseptic povidone - iodine solution ( kim - pa , poviiodeks , 10% povidone - iodine ) . then second - degree burn was created by a metal cylinder ( 1.5 cm i d , self - made ) immersed in boiling ( 100c ) water for three minutes and maintained on the back of rats for three seconds . all animals were resuscitated immediately with lactate ringer s solution ( 2 ml/100 g of body weight ) intraperitoneally . finally , each animal was placed in a separate cage . to avoid variations between experiments , normal saline group : immediately after burning , normal saline was applied topically onto the surface of burn areas , twice a day for 14 consecutive days . silversulfadiazine group : immediately after burning , ssd cream was applied topically onto the surface of burn areas , twice a day for 14 consecutive days . traditional preparation group : immediately after burning , traditional preparation was applied topically onto the surface of burn areas , twice a day for 14 consecutive days . the burn wound site was photographed with a digital camera ( sony cybershot dsc - p72 ) on days 1 , 4 , 9 and 14 . based on images obtained from the digital camera , the wound area was measured with image processing software ( digimizer 4.1.1.0 , persiangfx.com ) . the evaluated surface area was then used to calculate the percentage of wound contraction , tacking the initial size ( measured on day one ) of the wound as 100% using the following formula ( 17 ) . for microscopic studies , five rats from each group were killed on 4th , 9th and 14th days of experiment , and then burned area with a little normal skin was sampled . these tissue samples were kept in 10% neutral buffered formalin solution and sent to pathologic laboratory of veterinary medicine , shiraz university of medical sciences . after fixation in formalin solution , the skin tissues were embedded in paraffin , cut into 5 m sections , stained with hematoxylin and eosin dye . stained slides were observed for re - epithelization , collagen content , inflammatory changes , polymorphonuclear cells , vacuolization and fibroblast . the percentage of wound contraction was analyzed by statistical package spss 18.0 for windows ( ibm company ) . differences between groups in different days were estimated using one - way anova analysis of variance . the results of the burned area measurement are shown in table 1 , figures 1 and 2 . general parameters for the evaluation of wound healing , histopathological examination and measurement of the wound area were used .   on day 1 , the average diameter of wound in all groups was almost similar and there was no significant difference between these groups ( p < 0.05 ) . on 4th day , the size of wound was decreased in all groups but the percentage of wound contraction in ssd group was significantly greater than other groups ( p < 0.05 ) . on 9th day of trial , the wound area was lower significantly in all groups compared with 4th day . furthermore , wound contraction in ssd and traditional preparation groups were significantly greater than control and ns groups , but there was no significant difference between ssd group and traditional preparation group . on 14th day , as shown in table 1 , rats treated with ns , ssd and traditional preparation exhibited a significant ( p < 0.05 ) reduction in the size of wound compared with the control group . additionally , the percentage of wound contraction in the traditional medicine group was significantly greater than other groups ( figure 1 ) . histopathologic evaluations on fourth day after injury , severe inflammation and crust formation in all the experimental groups were seen . in addition , angiogenesis was observed in the traditional medicine group except these findings . on 9th day in both control and normal saline groups , severe inflammation and mild angiogenesis were seen . in ssd and traditional preparation groups , , collagen deposition was observed in both control and normal saline groups ( figure 2 ) . in ssd group , collagen deposition and chronic inflammatory cell infiltration were observed and in the traditional preparation - treated group , collagen deposition and epidermal regeneration were seen . a1 ) control group in day 4 , a2 ) control group in day 9 , a3 ) control group in day 14 , b1 ) normal saline group in day 4 , b2 ) normal saline group in day 9 , b3 ) normal saline group in day 14 , c1 ) silver sulfadiazine group in day 4 , c2 ) silver sulfadiazine group in day 9 , c3 ) silver sulfadiazine group in day 14 , d1 ) traditional medicine group in day 4 , d2 ) traditional medicine group in day 9 , d3 ) traditional medicine group in day 14 . each value represents the mean  sd for fifteen rats .   significantly different from silversulfadiazine group ( p < 0.05 ) .   significantly different from folk remedy group ( p < 0.05 ) . burn remains a major public health issue all over the word , especially in developing countries . burn wounds are painful maladies and entail a complex healing process ( 9 , 18 ) . the final aim of burn management and therapy is wound healing and epithelization as soon as possible to prevent infection and reduce functional and aesthetic after effects ( 8 , 19 ) . wound healing is a collaborative process involving a variety of cells and matrix components interacting continually towards a common goal ( 20 ) this process is characterized by three stages of inflammation , proliferation and remodeling . the proliferative phase typically demonstrates angiogenesis , collagen deposition , granulation tissue formation , epithelialization and wound contraction ( 21 ) . barley grain contains a number of components associated with health benefits including tocotrienol , lignan , phytoestrogen , phenolic compounds and phytic acid ( 22 , 23 ) . barley is a folk remedy for bronchitis , burns , cancer , catarrh , chest , chilblains , cholecystosis , cholera , cough , debility , diarrhea , dyspepsia , fever , inflammation , measles , phthisis , puerperium , sores and urogenital ailments ( 24 ) . in the current study , there was a significant difference regarding mean percentage of wound contraction between days 4 , 9 and 14 of experiment in all groups . the results indicated that both traditional preparation and ssd significantly ( p < 0.05 ) promoted wound contraction and shortened epithelization period . these results here are also supported histologically by increased collagen deposition , angiogenesis and minimal inflammation in rats treated with traditional cream compared to other groups . they reported that using ns and ssd cream are effective in healing burn skin wounds in the rat model ( 25 ) . in another study , nikzad et al . investigated the effects of arnebia leaf on healing process of second - degree burn . this study showed that arnebia leaf did not have any effect on healing of second - degree burn wounds in rats ( 26 ) . in another research , shokouhi - sabet - jalali et al . revealed that topical honey in treatment of burn compared with normal saline accelerated the healing process and had valuable antimicrobial effect in promoting recovery of this kind of wound ( 27 ) . it has been established that visceral fat induces nitric oxide synthase ( 28 , 29).this enzyme generates nitric oxide ( no ) from amino acid l - arginine . no has antibacterial properties and plays a critical role in many phases of wound healing ( 30 , 31 ) . furthermore , main fatty acids of visceral fat of goat are c18:1 , c18:0 , c16:0 , c14:0 , c16:1 , c10:0 and c12:0 . they are useful as a nutritional source , solvent , vehicle and stabilizer of administered products and form a protective barrier for the skin . besides being important in processes of cellular inflammation , they have a great capacity of tissue regeneration and antimicrobial activity ( 32 , 33 ) . they studied the effects of polyunsaturated fatty acids on diminishing wound area and demonstrated that pufas may play an important role in wound healing ( 32 ) . furthermore , some ingredients in the barley seed ash might be responsible for wound healing . finally , this study affirmed that the mixture of visceral fat and barley seed ash as a traditional cream accelerated wound healing and wound contraction and promoted epithelization . according to the obtained results , beneficial effects of this traditional preparation in the healing of superficial skin wounds are comparable with ssd in rats . the present study indicated that this preparation could be applied in the treatment of burns and may be an alternative to the use of ssd and other routine treatments .
background : skin burn is one of the most common complications and remains a major public health issue worldwide.objectives:this experiment was conducted to study the effects of traditional medicine ( visceral fat and barely seed ash ) compared with silversulfadiazine ( ssd ) cream on healing burn wounds in rats.materials and methods : sixty adult male wistar rats were randomly divided into four groups of equal numbers ; each group consisted of 15 animals . 
 after sedation , type ii of skin burn with 1.5 cm diameter circle was created on the back of rats with a heated metal in boiling water . 
 group one was not treated and considered as control . 
 the burned areas in the second , third and fourth groups were applied twice a day with normal saline , ssd cream and traditional preparation , respectively . 
 percentage of the burn wound concentration and histopathological examinations were used as parameters of our study on days 4 , 9and 14 . 
 obtained data were compared between the groups and days.results:ssd cream and traditional preparation had better effects on burnt wound healing compared with control group . 
 furthermore , on the final day of study , the average percentage of wound concentration in traditional medicine group was significantly greater than other groups ( p < 0.05 ) . 
 this finding was supported and confirmed by histological examination as well.conclusions:traditional preparation significantly decreased inflammation and accelerated wound healing in treated rats . 
 furthermore , the findings of this study can be applied clinically in the future .