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Ekezie Jervas. et al. / International Journal of Medicine and Health Profession Research. 2(2), 2015, 43 - 50.
Available online: www.uptodateresearchpublication.com July – December 43
Research Article ISSN: 2394 – 7403
ALTERNATIVE WOUND HEALING EFFECTS OF COCONUT OIL EXTRACT USING
ADULT WISTAR RATS
1
OKafor Chimaobi Wilson,
2
Edibamode Ezon-Ebidor Innocent,
3
Ekezie Jervas*,
4
Okeke Chukwubuike Udoka
,
5
Iwuoha Greg,
6
Osuchukwu Ikechukwu Williams,
7
Ezejindu Damian Nnabuihe
1
Department of Biomedical Technology, Federal University of Technology, Owerri, Nigeria.
2
Department of Anatomy, University of Port Harcourt, Nigeria.
3
*Department of Anatomy, Federal University of Technology, Owerri, Nigeria.
4,6
Department of Prosthetics and Orthotics, Federal University of Technology, Owerri, Nigeria.
5
Department of Public Health, Federal University of Technology, Owerri, Nigeria.
7
Department of Anatomy, Faculty of Basic Medical Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State,
Nigeria.
.
INTRODUCTION
Wound healing is an intricate process where the skin
or other body tissue repairs itself after injury. In
normal skin, the epidermis (surface layer) and
dermis (deeper layer) form a protective barrier
against the external environment. When the barrier is
broken, an orchestrated cascade of biochemical
ABSTRACT
Introduction
The occurrence of wound is a common phenomenon as long as the body is exposed to environmental forces, and the problems of
treating them are as old as mankind. Objectives: This study aimed at developing an applicable and cost effective wound treatment
agent, using indigenous material such as coconut oil, to enhance the wound healing processes via animal model. Materials and
methods: Coconut oil was obtained from coconut milk extract of twenty (20) fresh coconuts, each weighing between 200-230 g.
Fifteen (15) male wistar rats weighing approximately 192g - 226g were used. They were grouped into a control (C), standard (S)
and experimental (E) groups, with each comprising of five (5) rats. A wound size of 2cm by 2cm was inflicted on the dorsolateral
aspect of the thorax of the rats. The animals in the control group were dressed with distilled water, those in the standard group were
dressed with hydrogen peroxide (methylated spirit) and those in the experimental group were dressed with coconut oil. Wound size
measurement and dressing were done every three (3) days, until their wounds were completely healed. Results: The percentage (%)
mean wound contraction on day 9 of the C group (39.3 ± 5.2) against the E group (69.8 ± 3.8) was found to be statistically
significant (P < 0.05). The mean healing day of C group (28.8 ± 1.6) against the E group (18.6 ± 1.3) was found to be statistically
significant (P < 0.05). The percentage mean wound contraction on day 9 of the S group (59.0 ± 5.5) against the C and E groups
respectively, were found to be statistically significant (P < 0.05). The mean healing day of the S group (22.8 ± 1.6) against the C and
E groups, were found to be statistically significant. Conclusion: This study has shown that rats treated with coconut oil extract had
fewer days of wound healing and this was evident considering the wound contracture.
KEYWORDS
Contracture, Healing, Methylated spirit and Coconut.
Author for Correspondence:
Ekezie Jervas,
Department of Anatomy, Federal University of
Technology, P.M.B 1526, Owerri, Nigeria.
Email: ekeziejervas@gmail.com
International Journal of Medicine
and
Health Profession Research
Journal home page:
www.ij
mhpr.com
Ekezie Jervas. et al. / International Journal of Medicine and Health Profession Research. 2(2), 2015, 43 - 50.
Available online: www.uptodateresearchpublication.com July – December
44
events is quickly set into motion to repair the
damage
1,2
. Wound healing, as a normal biological
process in the human body, is achieved through four
precisely and highly programmed phases:
hemostasis, inflammation, proliferation, and
remodeling. For a wound to heal successfully, all
four phases must occur in the proper sequence and
time frame
3
. The events of each phase must happen
in a precise and regulated manner. Interruptions,
aberrancies, or prolongation in the process can lead
to delayed wound healing or a non-healing chronic
wound
4
. Wound contracture is a process that occurs
throughout the healing process, commencing in the
fibroblastic stage
5
.
Wound care in long-term care continues to be a
difficult issue. The utilization of proper wound care
techniques is essential in promoting healing. Product
cost, nursing time, patient comfort, and infection
control issues need to be considered
6
. The treatment
of acute and chronic wounds is an ancient area of
specialization in medical practice, with a long and
eventful clinical history that traces its origins ancient
Egypt and Greece. The Ebers Papyrus, circa 1500
BC, details the use of lint, animal grease, and honey
as topical treatments for wounds
7
. Dressings may
play an important adjunctive role in concert with
overall efforts to manage the underlying causes of
chronic non-healing wounds. Wound dressings have
undergone an evolutionary process from natural
materials that simply covered and concealed the
wound, to materials that focused on moisture
management and more recently, to materials that
either deliver active ingredients or interact directly
with cells or specific chemicals in the local wound
environment
8
. Even with an extensive array of
research available to discount their place in wound
care, wet-to-dry dressings continue to be used.
Moisture dressings have shown promise in reducing
pain and infection and promoting healing
6
.
Wound management is a significant clinical and
economic problem
9
. There is a paucity of
information on the actual cost of wound management
in Nigeria. Studies have calculated the cost of
wounds to the NHS in United Kingdom to about £1
billion a year
10
. Studies also revealed that 31.55% of
the total hospital patients at a Nigeria Teaching
Hospital were being managed for wounds. The cost
to the health system can be very significant; this
particularly is so in a developing country like
Nigeria
11
. Therefore in this study, we research to
ascertain the effect of coconut oil on wound healing
processes with respect to wound contraction. This
may be a cheaper and good alternative for wound
healing since coconut, an indigenous plant is readily
available.
MATERIAL AND METHODS
Plant Materials
Coconuts (Cocosnucifera L.) weighing 200-230 g
were obtained from Umuokeh Community, in
Obowo L.G.A., Imo State of Nigeria. It was
authenticated and identified by Iwueze Francis O., of
the department of Forestry and Wildlife, School of
Agricultural Technology, Federal University of
Technology, Owerri; as a dwarf (autogamous)
Coconut (Cocosnucifera L. Arecaceae). The fresh
coconut oil was obtained from the coconuts.
Experimental Animal
A total of 15 adult male Wistar rats with body
weights of192g-226g obtained from the breeder in
the animal house of Department of Human
Physiology, University of Port Harcourt, Choba,
Nigeria, were used in the study. The animals were
housed in standard environmental conditions where
they were fed with standard rodent diet and given
water ad libitum. The animals were acclimatized in
the laboratory conditions for 2 week before the
commencement of the study. The experimental
procedures adopted in this study were in strict
compliance with the United States National Institutes
of Health Guidelines for Care and Use of Laboratory
Animals in Biomedical Research (1985, no. 85-23)
12
.
Methods
Extraction of Coconut oil
Twenty coconuts (Cocosnucifera L) were obtained;
the exocarp and mesocarp were removed. After that,
the endocarp (meat) was blended using a blender.
The coconut water which obtained from the coconuts
was added to the blended coconut and mixed. After
which, the blended coconut particles (chaffs) were
sieved and squeezed out of the mixture, leaving the
liquid remnant which is a mixture of the coconut
Ekezie Jervas. et al. / International Journal of Medicine and Health Profession Research. 2(2), 2015, 43 - 50.
Available online: www.uptodateresearchpublication.com July – December
45
milk and coconut water. The liquid remnant is heated
to evaporate the water present thereby leaving the oil
which comes settle on top of the coconut cake that is
being formed. The coconut oil was then carefully
filtered in a clean sterile bottle and stored in glass
case maintained at room temperature.
Experimental Groups and Protocol
The rats were divided randomly into 3 groups
comprising 5 rats in each group. They were all fed
with the same diet throughout the experimental
period. The experimental design is described as
follows:
Anaesthesia
On expiration of the acclimatization, the rats from
the respective groups were an anesthetized one at a
time. This was done by clapping and shaving the
dorsal aspect of each animal, and then the area
cleaned with 70% ethanol. This was followed by
(intramuscular) I/M injection of 10mg/kg body
weight ketamine hydrochloride and 5mg/kg body
weight zylazine by injecting the animals with 0.3ml
of equal mixture of Diazepam and ketamin intra-
muscularly.
Infliction of Wound
When animal attained a subconscious state, at the
dorsolateral aspect of the thorax using a sharp razor
with the help of a forcep, a 2cm by 2cm square full
thickness circular excisional wound including all
layers of skin; after determination the area of each
wound with a marker wound was inflicted on the
skin of the shaved region.
Mode of Dressing
This was done by covering the wound with gauze
soaked in coconut oil and firmly secured with a
plaster in the experiment group, also a gauze soaked
in hydrogen peroxide (methylated spirit) and firmly
secured with a plaster in the standard group, while
the control group were dressed as well with the
wound covered with gauze soaked with distilled
water and secured with plaster. The wound was re-
dressed after every seventy two (72) hours, that is
every three (3) days.
Assessment of Wound Contraction
This was done by placing a white transparent sheet
of about 5cm square on the wound after the plaster
and gauze had been removed after each three days
interval, and then marking the sized of the wound on
the white transparent sheet using a felt pen. The
marked part was calculated by counting the number
of square blocks of graph sheet that falls within the
circumference when placed on the graph sheet.
Statistical Analysis
Data were analyzed using SPSS. One-way Analysis
of Variance (ANOVA) was applied and the
significant means were separated using the Duncan
multiple range test. The significance of differences
was calculated by using student t-test. P<0.05 was
considered statistically significant.
RESULTS
A better healing pattern was observed in Wister rats
treated with methylated spirit (Standard group) and
coconut oil and (Experimental group), with complete
wound closure observed within 24 days and 18 days
respectively; while it took about 30 days in wistar
rats treated with water (Control group) as shown
(Figure No.1). There was a significant reduction in
wound area from day three onwards in treated Wistar
rats and also on later days the closure rate was much
faster than when compared with control wistar rats.
However, in some of the control wistar rats we
observed that the wound size increased on day 24,
with subsequent death of the animals on day 30.
DISCUSSION
Excision wound model are often used for wound
healing bioassays because they represent a true
wound that could be reproducibly analyzed in a non-
subjective highly controlled manner
13
. Wound
healing involves a complex and superbly
orchestrated interaction of cells, extracellular matrix
and cytokines
14
. Granulation, collagen maturation
and scar formation are some of the cascade of wound
healing which run concurrently, but independent of
each other
15
. Multiple factors can lead to impaired
wound healing. In general terms, the factors that
influence repair can be categorized into local and
systemic. Local factors are those that directly
influence the characteristics of the wound itself,
while systemic factors are the overall health or
disease state of the individual that affect his or her
ability to heal. Many of these factors are related, and
Ekezie Jervas. et al. / International Journal of Medicine and Health Profession Research. 2(2), 2015, 43 - 50.
Available online: www.uptodateresearchpublication.com July – December
46
the systemic factors act through the local effects
affecting wound healing
3
. In modern biomedical
area, development for the management of wound
healing is an expensive program for the people of
developed countries, several drugs obtained from
natural sources
16-25
are known to increase the healing
and repair processes of different types of infected
wounds
26
.
Wound contraction is considered an important factor
in the evaluation of healing process in large open
wounds
27
. In this study, a close examination of
wound healing of animals in the control, standard
and experimental groups respectively showed that on
day 9 (Table No.2), wounds treated with distilled
water (control) had a percentage mean wound
contraction of (39.34 ± 6.3), while those treated with
hydrogen peroxide methylated spirit (standard) had
percentage mean wound contraction of (59.00 ± 2.3),
and those treated with coconut oil (experiment) had a
mean wound contraction of (69.84 ± 4.5). The results
depicts a significant increase (p<0.05) in the wound
contraction of the experimental group (Wister rats
treated with coconut oil) compared to the
experimental group (Wister rats treated with
methylated spirit) and control group (Wister rats
treated with distilled water). However, Aloe veraacet
one extract on full thickness excisional wounds
results in more accelerated contraction of treated
wounds with 100% contraction rate at 11
th
day post-
wounding
28
, while A. indica and T. cordifolia treated
wounds which showed 95.65% and 77.02% mean
wound contraction on the 21
st
day respectively;
which also showed a significant increase compared
to the control group
29
.
A drug to be used for effective wound healing
should be able to clear the wound by the 19
th
day
after infliction. A hundred percent (100 %) healing
was achieved in animals treated with ointments
containing 100 mg/g of NI in cationic emulsifying
agent and in the ointment containing Cicatrin
powder, by the 19
th
day after treatment, as the wound
sizes reduced to zero
30
. Also, this study showed
(Table No.3) that a complete wound healing was
achieved in coconut oil treated wounds on the 18
th
day. The wound healing day obtained in the
methylated spirit and distilled water treated Wister
rats were 24 days and 30days, respectively. It was
also observed that two out of the five rats that were
treated with distilled water died before the 30
th
day.
The delayed wound healing and death can be due to
contamination of the wound
31
. Base on this study,
coconut oil showed a more efficient wound healing
potential when compared to the complete wound
healing achieved with A. indica (21 days) and T.
cordifolia (21 days) treated wound
29
. The wound
contraction and healing effect of coconut oil can be
attributed to its antioxidant
32
and antibacterial
property, as a result of high monolaur in content
33-36
.
Thus, coconut oil achieved its therapeutic effect on
wound healing by its ability to overcome some
factors that militate against faster wound healing.
Recommendation
The inclusion of coconut oil into the list of
therapeutic agents, and its applications in cutaneous
wound management, would be a step-in the right
direction. Also, more investigations into the
molecular interactions of coconut oil and other living
tissues would be necessary.
Group Protocol
Control group (C) Rats were fed with pellets and water, wound was
inflicted, and dressed with distilled water and gauze.
Standard group (S) Rats were fed with pellets and water, wound was
inflicted, and dressed with methylated spirit and gauze.
Experimental group (E) Rats were fed with pellets and water, wound was
inflicted, and dressed with coconut oil and gauze.
Ekezie Jervas. et al. / International Journal of Medicine and Health Profession Research. 2(2), 2015, 43 - 50.
Available online: www.uptodateresearchpublication.com July – December
47
Table No.1: Percentage Wound contraction WC for control group (C), standard group (S) and
experimental group (E) at day 9
S.No
Sample %WC for C Group (X
1
) % WC for S Group (X
2
)
%WC for E Group (X
3
)
1 1 32.61 56.40 68.51
2 2 31.14 56.29 68.68
3 3 37.67 53.87 59.93
4 4 45.98 57.12 71.53
5 5 42.19 60.21 70.00
Mean 37.92 56.78 67.73
% = Percentage, WC = Wound contraction, X
1 =
C group, X
2
= S group, X
3
= E group
Table No.2: Paired Samples Test for Percentage Wound Healing at Day 9
Paired Differences
Mean Std.
Deviation
Std.
Error
Mean
95% Confidence
Interval of the
Difference T D
f Sig. (2-
tailed)
Lower
Upper
Pair
1
CONTROL
-
STANDARD -18.86000* 5.72819 2.56172 -25.97249 -11.74751 -7.362 4 0.002
Pair
2
CONTROL
-
EXPERIMENTAL -29.81200* 6.63308 2.96640 -38.04806 -21.57594 -10.050 4 0.001
Pair
3
STANDARD
-
EXPERIMENTAL -10.95200* 3.18781 1.42563 -14.91019 -6.99381 -7.682 4 0.002
*. The mean difference is significant at P < 0.05.
Table No.3: Paired Samples Test for Mean Wound Size at day 18
Paired Differences
Mean Std.
Deviati
on
Std.
Error
Mean
95% Confidence
Interval of the
Difference t df Sig. (2-
tailed)
Lower Upper
Pair
1
CONTROL
-
STANDARD 0.55800* 0.26117 0.11680 0.23371 0.88229 4.777 4 0.009
Pair
2
CONTROL
–
EXPERIMENTAL 1.19429* 0.11692 0.05229 1.04911 1.33946 22.841 4 0.000
Pair
3
STANDARD
-
EXPERIMENTAL 0.63629* 0.19261 0.08614 0.39713 0.87544 7.387 4 0.002
*. The mean difference is significant at P < 0.05.
Ekezie Jervas. et al. / International Journal of Medicine and Health Profession Research. 2(2), 2015, 43 - 50.
Available online: www.uptodateresearchpublication.com July – December
48
Figure No.1: Differential wound healing in Wister rats treated with water (control), methylated spirit
(standard) and coconut oil (experimental)
CONCLUSION
The profound wound contraction and healing effect
of coconut oil on Wister rats as documented in this
study, is a clear indication of its ability to enhance
healing through the prevention of infection and
inhibition of prolonged inflammation. These were
achieved as result of the antibacterial and antioxidant
activities of coconut oil in the model animals.
ACKNOWLEDGEMENT
The authors are sincerely thankful to Department of
Anatomy,
Federal University of Technology, Owerri,
Nigeria
for providing the facilities to carry out this
research work.
CONFLICT OF INTEREST
We declare that we have no conflict of interest.
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Please cite this article in press as: Ekezie Jervas et al. Alternative wound healing effects of coconut oil extract
using adult wistar rats, International Journal of Medicine and Health Profession Research, 2(2), 2015, 43-50.
