Abstract
BACKGROUND: Sepsis disrupts normal wound healing and causes organ damage through a systemic inflammatory response. Pomegranate (Punica granatum) is a natural antioxidant rich in polyphenols, such as ellagitannins and punicalagins, and has demonstrated potential anti-inflammatory and tissue-healing properties in various preclinical models. OBJECTIVE: This study aimed to evaluate the effects of pomegranate extract administered before and after sepsis induction on wound healing in a cecal ligation and puncture (CLP) rat model. METHODS: Thirty-eight male Wistar rats were divided into four groups: sham (n = 8), sepsis (n = 10), pre-sepsis pomegranate (n = 10), and post-sepsis pomegranate (n = 10). Sepsis was induced via CLP. Pomegranate extract (100 µL) was administered by oral gavage for seven days before or after sepsis. Rats were sacrificed on postoperative day 7. Biochemical (alanine transaminase (ALT), AST (aspartate transaminase), urea, creatinine) and histopathological (granulation, lymphocyte infiltration, fibrosis, acute inflammation) parameters were evaluated. Statistical analysis included Kruskal-Wallis and Fisher's exact tests. RESULTS: ALT levels were significantly lower in the pre-sepsis pomegranate group compared to the sepsis (p = 0.003) and post-sepsis pomegranate (p = 0.009) groups. Creatinine levels were significantly lower in the post-sepsis pomegranate group compared to the sepsis group (p = 0.007). Granulation tissue scores were significantly lower in the pre-sepsis pomegranate group compared to the sepsis and post-sepsis pomegranate groups (p = 0.038). There was no significant difference in fibrosis or lymphocyte density between the groups. CONCLUSION: Pretreating with pomegranate extract before inducing sepsis may protect against liver injury and support wound healing. Although the animals in this group were sacrificed earlier due to clinical deterioration likely related to the severity or timing of the sepsis, their biochemical and histological findings were favorable compared to those in the sepsis-only group. Our findings indicate that pomegranate extract, a readily accessible and well-tolerated natural product, may offer therapeutic benefits in the adjunctive care of septic patients.