Abstract

Background:
The incidence of wound complications after breast cancer surgery is > 30%. Delayed wound healing increases the risk of systemic recurrence up to three-fold after excisional surgery for primary breast cancer. Patients with breast malignant tumors, exhibit immune system dysfunction while T cells play a major role in the inflammatory process of wound healing. The time required to achieve wound closure depends on the severity of the wound. The content of piper crocatum ethanol extract contains alkaloids, flavonoids, tannins, steroids, and polyphenols. Flavonoid and polyphenol compounds are antioxidant, antidiabetic, anticancer, antiseptic, and antiinflammatory.

Aim:
To determine whether piper crocatum extract increases IL-10 levels, TGF-β1 and VEGF expression, collagen density, and the clinical features of wounds, and how the mechanism works on wound healing of Wistar rats after excision of mammary tumors.

Methods:
This study used 35 female Wistar rats, 30 mammary tumor models by injecting 3-5% benzopyrene as much as 50 mg/kg.BW in 5 injections into the mammary glands/mammae every 2 days as much as 10 mg/kg.BW. The 30 rats were divided into 5 groups; red betel extract gel 50%, 25%, 12.5%; povidone iodine (PI) group as a positive control; and carboxymethyl cellulose natrium (cmc na) group as a negative control, 5 normal wounds as controls. Treatment was given 2 times a day for 14 days.

Results:
Multiple linear regression results; Piper crocatum extract decreased IL-10 levels by -0.64 (p = 0.025), decreased TGF-β1 expression -0.832 (p = 0.001), increased VEGF expression by 0.638 (p = 0.026), and decreased collagen density by -0.605 (p = 0.037) in mammary tumor post-excision rat wounds.

Conclusion:
The mechanism of the effect of Piper crocatum extract on the wounds of Wistar rats post-excision of mammary tumors through decreased IL-10 levels and TGF-β1 expression, increased VEGF expression, and decreased collagen density through increased VEGF expression.

Key words: Piper crocatum extract, IL-10 level, TGF-β1 expression, VEGF expression, Collagen density