MODE OF ACTION OF TOPICAL USE OF SUCRALFATE
In the process of regeneration, Sucralfate being structurally similar to Heparin mimics the action of Heparin and binds to activate bFGF and protects it from inter-cellular enzymes released from damaged cells. This helps in mitosis and angiogenesis. It also increases the thickness of granulation tissues in full thickness wound.
Sucralfate exerts anti-bacterial effect by enhancing macrophagic activity at the tissue-infected area through angiogenesis. It ensures increased accumulation of skin macrophages, which engulf the bacteria by phagocytosis. Sucralfate produces antibacterial activity against P. aeruginosa, Staph. aureus, E.coli, P.mirabilis & Klebsiella are the common wound pathogens.
Due to rapid angiogenesis, there is strong macrophagic activity at wound site due to more blood flow. Hence, more phagocytic activity reduces bacterial overgrowth. Strong angiogenesis enhances the systemic anti-biotic concentration at the wound site. Thus reduces the risk of secondary infection.
Sucralfate provides anti-inflammatory effects at the wound site by preventing the release of 2 important cytokines – interferon gamma and interlukin-2 selectively from the damaged cells.