Topical sucralfate for treatment of mucocutaneous conditions: A systematic review on clinical evidences

Abstract

Sucralfate is an aluminum salt of sucrose octasulfate, generally considered safe in terms of adverse effects. Systemic sucralfate is FDA-approved for the treatment of duodenal ulcers. Since 1991, topical sucralfate has been used in various mucocutaneous conditions, but it is not approved by the FDA yet. In this systematic review, the online databases were searched with appropriate keywords, and the papers were screened by the authors. After screening steps, the relevant articles were selected according to the inclusions and exclusions criteria. Finally, the full texts of 18 articles were included for final evaluations. In conclusion, topical sucralfate has some clinical benefit in several mucocutaneous conditions, including mucocutaneous inflammatory conditions (e.g., post-radiotherapy reaction, diaper dermatitis, keratoconjunctivitis sicca, etc.), mucocutaneous infectious disorders (e.g., peristomal wound reaction/ infection); ulcers; burns, and also pain relief.

Jacquet erosive dermatitis associated with commercial barrier cream

“…In addition to its healing properties topical sucralfate has been noted to alleviate pain during the healing process. 9 Several case reports 3,4,10 have suggested the use of topical sucralfate 4% in the aqueous solution used 3-4 times per day for the management of JED given its clinical benefit in reducing healing time and alleviating discomfort. Whilst various triggers of JED are noted in previous case reports, this is the first instance of a specific commercial product possibly triggering the clinical manifestation of JED.…”

“…The molecular mechanism in epidermal and dermal healing is through the promotion of growth factors thereby increasing angiogenesis, granulation tissue formation and re‐epithelisation. In addition to its healing properties topical sucralfate has been noted to alleviate pain during the healing process 9 . Several case reports 3,4,10 have suggested the use of topical sucralfate 4% in the aqueous solution used 3–4 times per day for the management of JED given its clinical benefit in reducing healing time and alleviating discomfort.…”

Topical sucralfate for prevention of peristomal wound reaction related to percutaneous endoscopic gastrostomy in children: A randomized controlled trial

“…Topical sucralfate as a mucoprotective agent, has been used in the treatment of various mucocutaneous conditions including peristomal skin disease, 10 pressure ulcer, 11 burn, 12 as well as post adenotonsillectomy analgesia in children 13 . The clinical study has supported the safety and efficacy of topical sucralfate and the anti‐inflammatory and the anti‐microbial activity properties of topical sucralfate 14–16 …”

“…Topical sucralfate as a mucoprotective agent, has been used in the treatment of various mucocutaneous conditions including peristomal skin disease, 10 pressure ulcer, 11 burn, 12 as well as post adenotonsillectomy analgesia in children. 13 The clinical study has supported the safety and efficacy of topical sucralfate and the anti-inflammatory and the anti-microbial activity properties of topical sucralfate [14][15][16] On one hand, several previous clinical and experimental studies have recommended a beneficial role for topical sucralfate in the treatment of mucocutaneous conditions and on the other hand, there is no clinical study on the use of topical sucralfate in the prevention of peristomal wound reaction in children undergoing PEG tube insertion. In this regard, we aimed to evaluate the efficacy of the prophylactic application of topical sucralfate in the prevention of peristomal wound reaction infection in children.…”

A double-network porous hydrogel based on high internal phase emulsions as a vehicle for potassium sucrose octasulfate delivery accelerates diabetic wound healing

“…Cell growth factors and chemokines are easily inactivated due to changes in external conditions, resulting in a greatly reduced curative effect. Sucrose octasulfate (SOS), as a nano-oligosaccharide factor, exhibits good drug stability and serves multiple roles, including the regulation of MMPs [ 10 ], stabilization of related growth factors [ 11 ], promotion of angiogenesis [ 12 ] and improvement of inflammatory response and oxidative stress [ 13 ]. There is strong clinical evidence that the wound dressings added with SOS salt have a good therapeutic effect on diabetic wounds [ 10 , 12 ].…”