The effect of Allium cepa 12% hydrogel on the appearance of caesarean section scars

132 Pages·2016·2.05 MB·English

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The effect of Allium cepa 12% hydrogel on the appearance of Caesarean Section scars

A research dissertation presented to the
Faculty of Health Sciences, University of Johannesburg,
as partial fulfilment for the
Master‟s Degree in Technology: Homoeopathy
by:

Alicia Gerber
200912559

Supervisor: _____________________________ Date: _________________
Dr Neil Gower
MTech Hom (UJ) CML (UNISA)

Co-supervisor: ______________________________ Date: _________________
Dr TebogoTsele-Tebekang
MTech Hom (UJ)
DECLARATION

I, Alicia Gerber declare that this is my own unaided work. This research dissertation is being
submitted for the degree of Master‟s in Technology: Homoeopathy at the University of
Johannesburg. It has not been previously submitted at any degree or examination at any other
Technikon or University.

_____________________________ _________________
Alicia Gerber Date

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ABSTRACT

A scar is a replacement of normal structures by fibrous tissue at the site of injury. Scarring
following surgery or injury is difficult to predict and both physicians and their patients are highly
concerned with minimizing scar appearances, even small improvements in scarring would add
value. A total of 100 million patients develop scars in the developed countries alone each year as
a result of 55 million elective operations and 45 million operations after trauma. In South Africa
the Caesarean Sections (CS) delivery rate is 20.6%, substantially above the accepted WHO of
10-15%. Conventional clinical treatments of scars are often associated with a need for multiple
therapeutic sessions as well as a number of side effects.

The study aimed to assess the effect of 12% (v/v) Allium cepa Mother Tincture (MT) in a
hydrogel solution on the appearance of caesarean section scars using the Patient and Observer
Scar Assessment scale (POSAS) and digital photographical evidence. A group of 40 females
completed the study and were between the ages of 18 and 50. Participants were divided into 2
groups of 20 participants each. The study followed a controlled study format and was conducted
over four consultations, four weeks apart, over a twelve week period (W0; W4; W8 and W12).

Participants were evaluated at each consultation with the POSAS as well as photographic
documentation. It has been demonstrated that the POSAS scale is a reliable and valid scale and
provides a unidimensional measure for scar quality. It appears to be the most comprehensive
assessment scale by taking into account the patient‟s assessment of their own scar.

The results of the POSAS showed that both hydrogel (control) and hydrogel medicated by
Allium cepa (12%) (treatment) were able to improve the general appearance of scars in all
parameters measured except for sensations of pain and itching. Allium cepa (12%) compared to
the control hydrogel, appeared to significantly improve the patient‟s own perception of scar
stiffness, thickness and overall opinion thereof. Even thought there was a lack of significant
difference between groups, Allium cepa (12%) appears to improve the vascularity, thickness,
relief, pliability, surface area and colour of scars to a greater extent than the control hydrogel and
it is evident that more research over a longer period of time is required.

It was concluded from this study that 12% Allium cepa in hydrogel was found to be effective on
the appearance of Caesarean Section scars and may be used in the construction of further
research studies.
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The conclusion or results of this study may not be quoted for use or proof of efficacy nor
substantiation of any context without the express permission of the Department of Homoeopathy,
University of Johannesburg.

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DEDICATION
“And whatever you do, whether in word or deed, do it all in the name of the Lord Jesus, giving
thanks to God.” Colossians 3:17
I dedicate this work to my inspiring parents, Louis and Amori Gerber, who has provided me with
all the love and encouragement needed to complete this, although the support sometimes needed
a passport. To my fiancé: Liam Smit, thank you for your inspiration, support and encouragement
along the way.

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ACKNOWLEDGEMENTS
There are a number of people without whom this dissertation might not have been written, and to
whom I am greatly indebted:

Dr Neil Gower Thank you for always finding time in your very busy schedule and
for the effort and patience spent on this dissertation. It was a
privilege to have you supervise this study.

Dr Tebogo Tsele Tebokang Thank you for all your kindness, time, quick responses and
understanding throughout this time.

Juliana van Staden For providing all the statistical guidance for the analysis of this
study.

Fusion Homoeopathics For manufacturing the medication used in the implementation of
the study.

All study participants This study could never have been completed without your
dedicated participation, belief and patience.

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TABLE OF CONTENTS
Page
TITLE PAGE
DECLARATION i
ABSTRACT iii
DEDICATION v
ACKNOWLEDGEMENTS vi
TABLE OF CONTENTS vii
LIST OF APPENDICES xi
LIST OF FIGURES xii
LIST OF TABLES xiii

CHAPTER ONE
INTRODUCTION 1
1.1 Problem statement 1
1.2 Aim of study 1
1.3 Benefits of study 1
1.4 Hypothesis 2
1.5 Null Hypothesis 2

CHAPTER TWO
LITERATURE REVIEW 3
2.1 Introduction 3
2.2 Anatomy of skin 4
2.3 Formation of scars 6
2.3.1 Wound healing 6
2.3.1.1 Haemostatic, inflammatory and migratory phase 7
2.3.1.2 Proliferation phase 7
2.3.1.3 Maturation phase 8
2.3.2 Primary and secondary wound healing 8
2.4 Factors that influence wound healing 9
2.4.1 Age 9
2.4.2 Oestrogen 9
2.4.3 Infection 10
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2.4.4 Diabetes Mellitus 10
2.4.5 Nutritional deficiencies 10
2.4.6 Obesity 11
2.4.7 Alcohol 11
2.4.8 Defective collagen synthesis 11
2.4.9 Genetic predisposition 11
2.5 Classification of scars 12
2.5.1 Non hypertrophic scars (NHS) 12
2.5.2 Fibro proliferative scars (FPS) 12
2.5.3 Facial atrophic post acne scars (FAPS) 12
2.5.4 Burn scars 13
2.6 Scars of Caesarean delivery 13
2.6.1 Subumbilical midline 13
2.6.2 Pfannenstiel 14
2.7 Assessment of scars 14
2.7.1 Appearance 14
2.7.2 Physical characteristics 15
2.7.3 Patient‟s symptoms 15
2.8 Conventional and current treatment of scars 16
2.8.1 Pressure therapy 16
2.8.2 Silicone gel sheeting 16
2.8.3 Intralesional corticosteroid treatment 17
2.8.4 Cryotherapy 17
2.8.5 Laser therapy 17
2.8.6 Radiotherapy 17
2.8.7 Vitamin A 18
2.8.8 Vitamin E 18
2.8.9 Bio-oil® 18
2.9 Homoeopathy 19
2.9.1 Homoeopathic mother tinctures 19
2.9.2 Allium cepa mother tincture 19
2.10 Hydrogel 21
2.11 Related research 21

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