Saad Yaareb Jumaah, Ahmed N Abedsalih
Multidrug‑resistant Pseudomonas aeruginosa poses a major challenge in wound care, with standard therapy such as silver sulfadiazine (SSD) increasingly limited by cytotoxic side effects. Curcumin, a polyphenolic compound from Curcuma longa, offers a biocompatible alternative with established antibacterial, anti‑inflammatory, and wound healing properties. This study compared the therapeutic efficacy of a topical curcumin gel with 1% SSD cream in MDR P. aeruginosa-infected excision wounds in rabbits. Twenty‑five male New Zealand white rabbits were divided into five groups: negative control, positive control, curcumin gel, SSD, and carbopol vehicle. Outcomes were assessed over 21 days by in vitro antibacterial activity, wound contraction, serum IL‑6 levels, and histopathological/histomorphometry analysis. Curcumin exhibited dose‑dependent antibacterial activity, with an inhibition zone of 14.09 mm at 2.0 MIC, comparable to SSD (15.44 mm). In vivo, curcumin gel achieved the highest early wound contraction at day 7 (62.06% vs. 46.14% for SSD), with final closure comparable between treatments (96.44% vs. 99.24%). Curcumin suppressed the pathological IL‑6 surge more effectively than SSD at day 14, confirming its dual antibacterial and NF‑κB‑mediated anti‑inflammatory effects. Histopathology revealed early vascular granulation (day 7), collagen remodeling (day 14), and complete organized re‑epithelialization with folliculogenesis and minimal inflammation by day 21. Epithelial thickness in the curcumin group (40.20 µm) was statistically similar to SSD (39.74 µm) and superior to controls. Overall, curcumin gel demonstrated potent antibacterial activity, superior early wound healing kinetics, effective immunomodulation, and complete tissue restoration, highlighting its preclinical potential as a biocompatible and efficacious alternative to SSD for MDR-infected wounds, warranting further clinical validation.