Use of chitosan mouth‑wash in radio‑chemotherapy induced oral mucositis: A case‑control study

Background: Oral mucositis (OM) is a common dose‑limiting and potentially serious complication of radio‑chemotherapy which leads to atrophy and ulceration of the mucosa and an increased risk of infection in immunosuppressed patients. Chitosan is a cationic polysaccharide commercially extracted from the shells of shrimps and crab. Chitosan has beneficial biological and antimicrobial properties with high potential for wound healing. It is biocompatible, biodegradable, non‑toxic, anti‑microbial, anti‑fungal, and a hydrating mucoadhesive agent. Aims: To evaluate the efficacy and safety of chitosan mouthwash in the treatment of OM and if it could be used as a routine protocol for the treatment of OM. Subjects and Methods: The study was conducted on 20 patients (10 cases and 10 controls) diagnosed with OM following radiochemotherapy. The study group received 1% freshly prepared chitosan mouthwash, and the control group received chlorhexidine mouthwash. Signs and symptoms were assessed using numerical rating scale (NRS), the WHO and OM Assessment Scale at 0, 10 and 20 days. Statistical analysis: Descriptive statistics, Friedman’s and Mann–Whitney U test were performed. Results: Statistically significant differences were seen in the NRS (P = 0), ulceration (P = 0.007), and WHO (P = 0.029) scores. Conclusions: Chitosan was found to be a more effective than chlorhexidine in the alleviation of symptoms of OM.