CHAPTER 1 THE PROBLEM AND REVIEW OF RELATED LITERATURE Introduction Skin is a main protection or barrier for preventing the

entry and invasion of pathogenic microbes to the body from the environment. For humans, wound cases are very common such as due to surgery, traumatic, skin burn and others which leads to loss of integrity of the skin as a bodys main barrier of outer surface. Wound healing is a very complicated process, as the body needs to not only close up the wound and clean out any debris and dead tissue, it then needs to fill in areas where tissue was lost and essentially connect the skin back together. It has its natural process with three phases, the inflammation phase, proliferation phase and re- absorption phase. It is influenced by many factors including the kind of medicine or drug used. The use of medicine or drugs is aimed to accelerate the wound healing process and to prevent infection. The different drugs used for wound treatment could be used in many ways and in kinds. One of these kinds used for treatment is herbal medicine. The use of

traditional medicinal remedies and plants in the treatment of wounds is an important aspect of health treatment and at the same time a way to reduce the financial burden. Several plants used as traditional healing remedies have been reported to treat skin disorders,

including wounds. One of the plants which have a great potential to be explored as medicinal plants is the banana plant. This plant grows

well, easily and found in huge number. People use this plant mainly for its fruit and leaves. The stem is mainly used for ruminant feed and some cultural activities but what caught the researcher's

attention is its therapeutic effects on wound healing. Banana stem contains serotonin, norepinephrine, dopamine, tannin, Vitamin A,

Vitamin B and Vitamin C that are very essential for the body in the wound healing process. The banana stem sap contain components that functioned as antibiotic and accelerated the growth of cell on the regeneration process, this stem sap also increases the blood flow and stimulates connective tissue formation on the response of wound

healing process. Banana stem sap could also be used for pain reliever and facilitate the increasing absorption capability of medicine in the skin, therefore, could be used to treat contusion, skin burn, animal bite and anti- inflammation. Therefore the researchers have decided to make an in depth study about the mentioned subject and prove that banana sap can accelerate and aid in wound healing compared to the natural process.

II. Review of Related Literature Wound healing varies depending on the utilization of medications or drugs that shall be using in case of alteration in skin integrity. The Researchers investigate the use of potential herbal plants as a treatment modality for wounds. There are existing literatures revealing that Banana sap was known to be a wound healing agent. According to Marvin (2011) applying banana trunk sap to wound is a common old practice. It was old because it was superseded by popular liquid iodine formulations, e.g. povidone iodine. The popular wound medicine can be applied to any wound without the pain. There was then a true experiment regarding the effect of using banana sap in

accelerating wound incision healing process and concluded that banana sap usage was proven to be more effective in accelerating incision healing process and reduce any infection risk (Sasongko, 2008). With regards to its effectivity it is said that based on experience, it is very much useful. The banana sap has a property that stops the bleeding after applying it to the wound. The sap contains saponin and ascorbic acid. The mentioned substances function on healing the wound faster (Marvin, 2011). Saponin works to increase the

formation of new blood vessels in the wound so that it supplies oxygen and nutrients more. Ascorbic acid functions to strengthen and accelerate the growth of connective tissue (collagen. (Nugrohoro, 2011) With 80 percent concentration of the sap of the banana tree, the wound will be closed 30-60 percent faster according Estiara (2010). The banana is one of the best fruit sources of vitamin B6

which

helps

with

the

production

of

neurotransmitters

including

serotonin and gamma-amino butyric acid (GABA). Moreover, it is also a wonderful source of vitamin C, along with modest amounts of the B group vitamins folate, niacin, riboflavin and pantothenic acid which are very essential for the body in the wound healing process

(Drucker, 2004). Other parts of the banana tree is also as useful as its trunk in helping a wound to heal and lessens its damage. As a matter of fact the pounded peels of ripe bananas can be used to make a poultice or dressing for wounds and aside from that the inside of the peel has anti-septic properties that can be wrapped directly around wounds or cuts in case of emergency (Sharrock,1996,p.42).

Relating the effect of banana sap in the hastening of wound healing in mice there is a research that aims to find out the

activity of banana stem sap on the acceleration of wound healing process in the mice skin based on gross and histopathological

observations. Totally 45 heads of DDY mice ages 4 6 weeks were used in this study. The mice were divided into three groups, negative control, positive control, and banana stem sap. All mice were 1 1.5 cm incised on the dorsal back skin. The test result indicated that banana stem sap could promote the wound healing process. Gross lesion observation indicated that in the banana stem sap treatment, the scab formation was faster than negative control and Bioplacentation.

(Beiheft, 1990, p. 32).

Conceptual/ Theoretical Framework INPUT PROCESS OUTPUT Increased in the extent of the healing of cut wounds of the albino mice in terms of: a. Healing time b. Appearance c. Size

a. Selection and a. Induction of cut Control of Albino wound Mice b. Application of b. Collection of Treatment (Banana Sap) Banana Stem Sap on subject A and no treatment on subject B. c. Observation of wound healing process using assessment tools

This framework shows the simple flow of how the study shall be conducted. During the input phase, Albino mice that shall be selected will be of the same sex and age (4 6 weeks old). Their food intake for 7 days shall be controlled through giving same amount and kind

of food and drinks. Before the process phase starts, collection of banana stem sap shall be done. On the process phase, a cut wound shall be induced on the mice using a devised scalpel with the same length of wound. Fresh banana stem sap shall be applied on subject A (experimental) and no treatment given to subject B (Negative Control). The mice shall be observed everyday for 14 days using the Wound Assessment Tools.

After the mice have been observed for 14 days, the result should show an increase in the extent of the healing of cut wounds in terms of healing time, appearance and size. This will serve as a map that would give coherence to all empirical inquiries.

Statement of the Problem This study is aimed to evaluate the effectiveness of Banana Sap in healing the cut wounds of Albino rats. Specifically, it seeks to answer the following: 1. What is the extent of the effectiveness of Banana sap in in terms

healing cut wounds of the albino mice A (experimental) of: a. Healing time b. Appearance c. Size 2. What is the extent of

the healing of cut wounds of the albino in terms of:

mice B ( negative control) a. Healing time b. Appearance c. Size

3. Is there a significant difference in the extent of the healing of the cut wounds between subject A and subject B in terms of: a. Healing time b. Appearance c. Size

Hypotheses There is no significant difference in the extent of healing of the cut wounds of subject A to that of subject B.

Significance of the study Specifically, the researchers envisioned that the result of this study will serve as: I. An alternative medication for cut wounds. II. An economical alternative medication for

people having cut wound. III. A way of promoting the benefits of banana

sap for cut wounds. IV. Assessment of the effectiveness of the

various functions of banana sap. V. Alternative medicine for people below the poverty line. In the light of the framework within which banana sap is used as an alternative aid in wound healing, the researchers envisioned that the result of the study will significantly be beneficial to: A. The community people and others belonging to low socioeconomic statusthe results shall give first-hand knowledge about

effectiveness of the intervention and would serve as its purpose which is to use as an alternative medicine for wounds. B. Researchers- the result of the study can be utilized among the researchers healing. C. Future researchersthe study may serve as a foundation or in particular phenomenon significant to wound

references for significant future studies.

Scope and Limitation This research study aims to evaluate the effectiveness of banana sap in cut wounds of Albino mice, which may serve as an

alternative treatment for commercially prepared solutions. This ought to determine the length of time it shall take the cut wound to heal. The group will be using two albino mice - one as a negative control (no treatment) and one given with treatment

(banana stem sap). The treatment shall be banana stem sap from Lakatan banana tree. The sap may appear sticky clear to cloudy. The Albino mice will be bought at the Department of Science and Technology (DOST). The mice will be observed for 14 days using the wound assessment tool to compare the appearance, size and healing time. The experiment shall be conducted at Saint Paul University Philippines' Science Laboratory. The researchers shall be

maintaning same environment and physiologic needs of both mice such as housing, food and drinks. The researchers knowledge is limited only in wound healing and care, and may consult a

biologist for assistance.

Definition of terms Albino mice a kind of rat which is commonly used for laboratory experimentation.

Banana stem sap liquid coming out from the stem of Lakatan banana tree after being cut.

Cut wound a kind of wound that is manually induced by using a devised scalpel.

Devised Scalpel instrument with a controlled depth of blade that will be used to induce cut wounds.

Wound healing intricate process in which the skin repairs itself after an injury and will be measured using the wound assessment tools in terms of appearance, size and length of time.

Chapter 2 METHODS AND PROCEDURES This chapter shall provide informations and details about the procedures and preparations needed for the study.

Research Design The researchers shall be using an experimental research in which, a treatment shall be given on subject A (experimental) and no treatment for the negative control. The researchers will attempt to maintain control over all factors such as the

environment (housing), physiologic needs like food and drinks, and the instrument (devised scalpel) used to induce wound to the Albino mice that may affect the result of the abovementioned experiment. In doing this, the researchers attempt to determine or predict the effectiveness of banana stem sap in wound

healing.

Instrumentation and Procedure Banana Sap Preparation 1. A Lakatan Banana tree will be identified in any area nearest to SPUP Science Laboratory . 2. The instruments such as scalpel and petri dish shall be autoclaved before being used. A sterile gloves shall also be utilized.

3. The banana stem shall be cleansed using cotton balls soaked in sterile water. 4. With a donned sterile gloves, the stem sap will be

collected directly from the banana stem by cutting it with a scalpel aseptically. The sap collected shall be placed in a petri dish.

Albino Mice A. Preprocedure Preparation 1. Two Albino mice with the same sex and age (4 6 weeks old) shall be bought from the Department of Science and

Technology. 2. Healthy Albino mice shall individually be housed and be given the same amount and type of food and water. 3. The mice shall be periodically weighed before the

experiment to note equal weight gain.

B. Induction of Cut Wound 1. The right leg of the mice shall be shaved using a razor and will be left untouched for 24 hours. 2. The shaved leg shall be cleansed using cotton balls with sterile water in a circular pattern. 3. With a donned sterile gloves, a devised scalpel shall be used to induce a 3mm cut wound.

C. Treatment and Control 1. After inducing a cut wound, subject A (Experimental) shall be given the treatment only after 15 minutes while subject B (Negative control) shall remain as is. 2. After 15 minutes, using a sterile cotton swab, the

banana stem sap shall be gently applied over the incised portion of the mice. Note: The banana stem sap shall be collected and applied

everyday. Application should be of the same time and procedure. The mice shall be assessed prior to the application of each treatment. 3. The experimental and control subjects shall be observed for 14 days using the wound assessment tool for its appearance, size and length of healing time.

Data Analysis The data will be analyzed utilizing the following

statistical tools:

1.The mean of the wound area measurements between groups and the different time intervals will be gathered as part of the data analysis. 2. ANOVA will be used to examine the mean differences in wound healing between the group given with the Banana Stem Sap, and the other group that was given no treatment at all.

Appendix A Wound Assessment Tool

Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14

Banana Stem Sap

Negative Control

This tool shall be used for recording the length of the cut wound.

Appendix B

Wound Assessment Tool

Day # ___

Wound Assessment Textur e a. Moist b. Smooth c. Coarse d. Hard e. Soft f. Rough Color a. Reddish b. Pinkish c. Yellowish d. Blackish Wound Edge Charac terist ics a. Sloping b. Punched Out c. Rolled d. Averted e. Purple Wound Exudat es a. Serous b.Serosanguinous c. Sanguinous

Banana Stem Sap

Negative Control

This shall serve as a check-list for the wounds characteristic

References Website: Beiheft; 1990; Journal of Agriculture and Rural Development in the Tropics and Subtropics ; (http://books.google.com.ph/books?id=x21902h4rXYC&pg=PA35&lpg=PA35&dq=banana+sap +wound+healing&source=bl&ots=Yq_5YJoVRt&sig=mQPPOdksjGRbNfexNoDNZldlZZI&hl= tl&ei=JpesSCLDtGIkAXs5qSwDQ&sa=X&oi=book_result&ct=result&resnum=1&ved=0CAkQ 6AEwAA#v=onepage&q=ban)

Drucker; 2004; Australian Bananas Media Kit; (PDF file, http://www.australianbananas.com.au/public/media/downloads/media_kit.pdf)

Estiara; 2010;(http://doddyestiara.blogspot.com/2010/09/banana-tree-sap acceleratewound.html) Marvin; (2011); Banana Trunk Sap for Healing Wounds/ Saha Ng Saging; (http://www.luntiancorner.com/health/banana-wound-heal/). Nugroho; 2010; Banana Sap Heal Wounds; (http://www.allvoices.com/contributednews/6555672-banana-sap-heal-wounds)

Sasongko; (2001); Efek Pemberian Getah Tunas Pisang Raja terhadap Proses Percepatan Penyembuhan Luka Insisi pada Hewan Coba Mencit (Mus mus culus) Strain Balb/; ( PDF File; http://alumni.unair.ac.id/kumpulanfile/217828264_abs.pdf) Sharrock;1996;Uses of Musa; (PDF file,http://r0.unctad.org/infocomm/francais/banane/Doc/musa.pdf)