Research - Wound Healing
Nutrition and Wound Healing: An Overview Focusing on the Beneficial Effects of Curcumin
by Martina Barchitta 1,Andrea Maugeri 1,Giuliana Favara 1,Roberta Magnano San Lio 1,Giuseppe Evola 2,Antonella Agodi 1,* andGuido Basile 3
Wound healing implicates several biological and molecular events, such as coagulation, inflammation, migration-proliferation, and remodeling. Here, we provide an overview of the effects of malnutrition and specific nutrients on this process, focusing on the beneficial effects of curcumin. We have summarized that protein loss may negatively affect the whole immune process, while adequate intake of carbohydrates is necessary for fibroblast migration during the proliferative phase. Beyond micronutrients, arginine and glutamine, vitamin A, B, C, and D, zinc, and iron are essential for inflammatory process and synthesis of collagen. Notably, anti-inflammatory and antioxidant properties of curcumin might reduce the expression of tumor necrosis factor alpha (TNF-α) and interleukin-1 (IL-1) and restore the imbalance between reactive oxygen species (ROS) production and antioxidant activity. Since curcumin induces apoptosis of inflammatory cells during the early phase of wound healing, it could also accelerate the healing process by shortening the inflammatory phase. Moreover, curcumin might facilitate collagen synthesis, fibroblasts migration, and differentiation. Although curcumin could be considered as a wound healing agent, especially if topically administered, further research in wound patients is recommended to achieve appropriate nutritional approaches for wound management.
Source : International Journal of Molecular Sciences
Link to Full Article
Wound Healing and the Use of Medicinal Plants
Aleksandra Shedoeva,1 David Leavesley,1 Zee Upton,1,2 and Chen Fan
Cutaneous wound healing is the process by which skin repairs itself. It is generally accepted that cutaneous wound healing can be divided into 4 phases: haemostasis, inflammation, proliferation, and remodelling. In humans, keratinocytes re-form a functional epidermis (reepithelialization) as rapidly as possible, closing the wound and reestablishing tissue homeostasis. Dermal fibroblasts migrate into the wound bed and proliferate, creating “granulation tissue” rich in extracellular matrix proteins and supporting the growth of new blood vessels. Ultimately, this is remodelled over an extended period, returning the injured tissue to a state similar to that before injury. Dysregulation in any phase of the wound healing cascade delays healing and may result in various skin pathologies, including nonhealing, or chronic ulceration. Indigenous and traditional medicines make extensive use of natural products and derivatives of natural products and provide more than half of all medicines consumed today throughout the world. Recognising the important role traditional medicine continues to play, we have undertaken an extensive survey of literature reporting the use of medical plants and plant-based products for cutaneous wounds. We describe the active ingredients, bioactivities, clinical uses, formulations, methods of preparation, and clinical value of 36 medical plant species. Several species stand out, including Centella asiatica, Curcuma longa, and Paeonia suffruticosa, which are popular wound healing products used by several cultures and ethnic groups. The popularity and evidence of continued use clearly indicates that there are still lessons to be learned from traditional practices. Hidden in the myriad of natural products and derivatives from natural products are undescribed reagents, unexplored combinations, and adjunct compounds that could have a place in the contemporary therapeutic inventory.
Source : Journal Evidence Based Complementary and Alternative Medicine
Link to Full Article
Molecular Changes in Diabetic Wound Healing following Administration of Vitamin D and Ginger Supplements: Biochemical and Molecular Experimental Study
Hadeel A. Al-Rawaf,1,2 Sami A. Gabr,1 and Ahmad H. Alghadir
Background. Circulating micro-RNAs are differentially expressed in various tissues and could be considered as potential regulatory biomarkers for T2DM and related complications, such as chronic wounds. Aim. In the current study, we investigated whether ginger extract enriched with -gingerol-fractions either alone or in combination with vitamin D accelerates diabetic wound healing and explores underlying molecular changes in the expression of miRNA and their predicted role in diabetic wound healing.
Methods. Diabetic wounded mice were treated with -gingerol-fractions (GF) (25 mg/kg of body weight) either alone or in combination with vitamin D (100 ng/kg per day) for two weeks. Circulating miRNA profile, fibrogenesis markers, hydroxyproline (HPX), fibronectin (FN), and collagen deposition, diabetic control variables, FBS, HbA1c, C-peptide, and insulin, and wound closure rate and histomorphometric analyses were, respectively, measured at days 3, 6, 9, and 15 by RT–PCR and immunoassay analysis.
Results. Treatment of diabetic wounds with GF and vitamin D showed significant improvement in wound healing as measured by higher expression levels of HPX, FN, collagen, accelerated wound closure, complete epithelialization, and scar formation in short periods (11-13 days, (P<0.01). On a molecular level, three circulating miRNAs, miR-155, miR-146a, and miR-15a, were identified in diabetic and nondiabetic skin wounds by PCR analysis. Lower expression in miR-155 levels and higher expression of miR-146a and miR-15a levels were observed in diabetic skin wounds following treatment with gingerols fractions and vitamin D for 15 days. The data showed that miRNAs, miR-146a, miR-155, and miR-15a, correlated positively with the expression levels of HPX, FN, and collagen and negatively with FBS, HbA1c, C-peptide, and insulin in diabetic wounds following treatment with GF and /or vitamin D, respectively.
Conclusion. Treatment with gingerols fractions (GF) and vitamin D for two weeks significantly improves delayed diabetic wound healing. The data showed that vitamin D and gingerol activate vascularization, fibrin deposition (HPX, FN, and collagen), and myofibroblasts in such manner to synthesize new tissues and help in the scar formation. Accordingly, three miRNAs, miR-155, miR-146a, and miR-15, as molecular targets, were identified and significantly evaluated in wound healing process. It showed significant association with fibrin deposition, vascularization, and reepithelialization process following treatment with GF and vitamin D. It proposed having anti-inflammatory action and promoting new tissue formation via vascularization process during the wound healing. Therefore, it is very interesting to consider miRNAs as molecular targets for evaluating the efficiency of nondrug therapy in the regulation of wound healing process
Source Journal Evidence Based Complementary and Alternative Medicine
Link to Full Article
The pro-healing effects of medical grade honey supported by a pediatric case series
Eleftherios Smaropoulos ab Niels A.J. Cremers c.
The development of antibiotic resistance demands for novel complementary therapies for wound care. We here present a case series on the use of medical grade honey (MGH) in pediatric wounds. We aim to illustrate the specific antimicrobial and pro-healing activity of MGH and support its easy and safe use.
Four pediatric patients with wounds of different origin are discussed in this prospective observational case series. All wounds were treated via monotherapy with daily MGH application.
Results and discussion
Wound covering with MGH prevents pathogen infiltration and has antimicrobial activity. Moreover, MGH keeps the wound moist and possesses strong pro-healing effects, such as autolytic debridement of non-vital tissue and restoration of vascular structures. The anti-inflammatory and anti-oxidative action of MGH together with the supplemented vitamins C and E may inhibit scar formation.
MGH is safe and easily applicable and can be recommended in all kinds of wounds.
Source : Complementary Therapies in Medicine
Link to Full Article
Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils
Tzu-Kai Lin 1 , Lily Zhong 2,* and Juan Luis Santiago 3,* 1 Department of Dermatology, Kaohsiung C
Plant oils have been utilized for a variety of purposes throughout history, with their integration into foods, cosmetics, and pharmaceutical products. They are now being increasingly recognized for their effects on both skin diseases and the restoration of cutaneous homeostasis. This article briefly reviews the available data on biological influences of topical skin applications of some plant oils (olive oil, olive pomace oil, sunflower seed oil, coconut oil, safflower seed oil, argan oil, soybean oil, peanut oil, sesame oil, avocado oil, borage oil, jojoba oil, oat oil, pomegranate seed oil, almond oil, bitter apricot oil, rose hip oil, German chamomile oil, and shea butter). Thus, it focuses on the therapeutic benefits of these plant oils according to their anti-inflammatory and antioxidant effects on the skin, promotion of wound healing and repair of skin barrier.
Topical applications of plant oils may have different effect on the skin according to their composition and the pathophysiological context of the skin. The composition varies by different extraction methods. When applied topically, constituents of plant oils (triglycerides, phospholipids, FFAs, phenolic compounds and antioxidants) may act synergistically by several mechanisms: (i) promoting skin barrier homeostasis; (ii) antioxidative activities; (iii) anti-inflammatory properties; (iv) direct and indirect (upregulation of antimicrobial peptides) anti-microbial properties; (v) promoting wound healing; and (vi) anti-carcinogenic properties. Future studies can add to current findings to allow for better understanding of these oils, with the potential to develop dermatological treatments and skin care products using these oils.
Source : Intl Journal Molecular Science
Link to Full Article
The Wound Healing Effect of Callicarpa nudiflora in Scalded Rats
Xu-guang Zhang,1,2 Xiu-min Li,1,2 Xin-xin Zhou,3 Yong Wang,1,2 Wei-yongLai,1,2 Ying Liu,1 Yu-chao Luo,1 and Jun-qing Zhang
Callicarpa nudiflora has been widely used in Li nationality medicine and treated burns and scalds in China. Our objective was to preliminarily elucidate healing effect and action mechanism of Callicarpa nudiflora water extract (CNE) on the scald wounds using an experimental rat mode. The second-degree scald wounds were induced by hot water on dorsal surface of Sprague-Dawley (SD) rats, and then they were randomly divided into 5 groups as follows: control (CON), Vaseline, Silver sulfadiazine (SSD), and Vaseline supplemented with 10% and 20% CNE groups. These ointments were employed locally once daily for 21 days. The macroscopic analysis showed CNE significantly accelerated the wound healing process and lowered the wound areas on days 15, 18, and 21 especially in 20% CNE group compared to CON group. Histopathological evaluation showed the mildly hypertrophic epidermis and the intact dermis in the 20% CNE-treated group were obviously distinguished from CON group on day 21. The CNE-treated groups had no obvious effect for TNF-α and IL-10 expressions on the second day and 14th day, while TGF-β1 expression level was decreased on the 21th day and VEGF level was increased on the 7th day in the 20% CNE group. Furthermore, the expression level of Samd3 was strongly inhibited in 20% CNE group. These findings suggested that the CNE can enhance the wound healing and skin repair in deep second-degree scald rats and thus support its traditional use.
Source : Journal Evidence Based Complementary and Alternative Medicine
Link to Full Article
Rosehip Oil Promotes Excisional Wound Healing by Accelerating the Phenotypic Transition of Macrophages
Zhiyong Lei, Zhijian Cao, Zaiwang Yang, Mingzhang Ao, Wenwen Jin, Longjiang Yu
Poor wound healing is a major and global threat to public health. Efforts have been made to better understand the underlying mechanisms and develop effective remedies, though the advancements that have been made are still limited. As there are no effective and generally applicable therapies available for skin injuries and fibrosis, it is urgent to develop new drugs and therapies that facilitate wound healing and effectively improve scars. In this study, GC-MS analysis was performed to identify the chemical composition of rosehip oil. The excisional wound healing model and the carrageenan-induced paw edema method were respectively applied to evaluate the wound healing activity and anti-inflammatory activity of rosehip oil. Hematoxylin and eosin staining was used to assess the pathological changes of sections, and Sirius-red staining was performed to analyze the ratio of collagen I/III in wound tissues. Immunohistological staining for CD68, CCR7 (CD197), CD163, TGF-β1, and α-SMA was applied to determine the macrophage phenotypes transition (M1-to-M2) and demonstrate the scar-improving efficacy of rosehip oil on wound healing. Results showed that rosehip oil significantly promoted wound healing and effectively improved scars. This efficacy might be exerted by accelerating the macrophage phenotypes transition and inhibiting the process of epithelial-mesenchymal transition.
Source : Journal Planta Medica
Link to Full Article
Investigating the effect of Sesame Ointment on Wound healing of Episiotomy
Najmeh Amani Babadi, Masoomeh Kheirkhah, Faraz Mojab, Hamid Haghani
Episiotomy is one of the most common midwifery interventions method for preventing injuries to the pelvic floor during the delivery process. Traditional medicine has a special place in improving the quality of postpartum care. Sesame is one of the herbs with anti-inflammatory, anti-bacterial and antioxidant activity. This study was evaluate the effect of sesame ointment on episiotomy healing. Methods: This randomized control clinical trial was performed on 104 eligible women. The samples were block randomly assigned to one of the groups Intervention and control. Samples were used sesame and placebo ointment for epizootics from 4 hours after delivery for ten days every 8 hours. Clinical evaluation of episiotomy ulcer was performed 4 hours, 7 and 10 days after delivery with using REEDA tool. SPSS software version 16 was used for data analysis. P value less than 0.05 was considered significant. Results: The average of wound healing rate was 7 days after episiotomy in the intervention group 0.09 ± 0.29 and in the control group was 0.73 ± 0.44. Independent t-test showed that the two groups had a significant difference (p <0.001).Healing of the wound 10 days after episiotomy showed that the mean scores in the control group (0.4 ± 0.49) and in the intervention group (0.02 ± 0.13), healing in the intervention group significantly decreased from the control group (p <0.001).
Conclusion: Sesame ointment can be used as a pain relief and accelerator for episiotomy healing.
Source : Internatitional Journal of Ayurvedic Medicine
Link to Full Article -download PDF
Wound healing potential of lavender oil by acceleration of granulation and wound contraction through induction of TGF-β in a rat model
- Hiroko-Miyuki Mori,
- Hiroshi Kawanami,
- Hirohisa Kawahata and
- Motokuni Aoki
Although previous studies have suggested that lavender oil promote wound healing, no study has examined the molecular mechanisms of its effect. In this study, we investigated the effect of lavender oil on various steps of wound healing and its molecular mechanism, focusing on transforming growth factor-β (TGF-β).
Circular full-thickness skin wounds were produced on rats. Control solution or lavender oil was topically applied to the wounds on alternating days for 14 days.
The area of wounds topically treated with lavender oil was significantly decreased as compared to that of wounds of control rats at 4, 6, 8, and 10 days after wounding. Topical application of lavender oil induced expression of type I and III collagen at 4 days after wounding, accompanied by an increased number of fibroblasts, which synthesize collagen. Induced expression of type III collagen by topical application of lavender oil was reduced to control level at 7 days after wounding although increased expression of type I collagen still continued even at 7 days, suggesting rapid collagen replacement from type III to type I in wounds treated with lavender oil. Importantly, expression of TGF-β in wounds treated with lavender oil was significantly increased as compared to control. Moreover, an increased number of myofibroblasts was observed in wounds treated with lavender oil at 4 days after wounding, suggesting promotion of differentiation of fibroblasts through induction of TGF-β, which is needed for wound contraction.
This study demonstrated that topical application of lavender oil promoted collagen synthesis and differentiation of fibroblasts, accompanied by up-regulation of TGF-β. These data suggest that lavender oil has the potential to promote wound healing in the early phase by acceleration of formation of granulation tissue, tissue remodeling by collagen replacement and wound contraction through up-regulation of TGF-β. The beneficial effect of lavender oil on wound healing may raise the possibility of new approaches as complementary treatment besides conventional therapy.
Source BMC Complementary and Alternative Medicine
Link to Full Article
In vitro antibacterial activity and in vivo efficacy of hydrated clays on Mycobacterium ulcerans growth
- Sarojini Adusumilli and
- Shelley E. Haydel
Buruli ulcer, caused by Mycobacterium ulcerans, is a localized skin lesion that can progress to extensive ulceration and necrosis if left untreated. Unpublished studies of hydrated clays for therapeutic, topical treatment of Buruli ulcer suggest that specific clay mineral products may have beneficial effects on wound healing. In this study, we evaluated the in vitroantibacterial activity of a panel of clay mixtures and their derivative leachates against M. ulcerans and assessed the in vivoefficacy of topically-applied, hydrated clays on Buruli ulcer progression in mice infected with M. ulcerans.
M. ulcerans 1615 was incubated with 10 % suspensions of CB07, CB08, CB09, CB10, and BY07 clay mixtures, and survival was determined over 28 days. For animal experiments, we examined the effect of topical hydrated clay therapy on Buruli ulcer progression in vivo in mouse tails subcutaneously infected with M. ulcerans 1615.
The CB07, CB08, and CB09 clays exhibited bactericidal activity against M. ulcerans after 7, 14, 21, and 28 days of incubation. In contrast, clay leachates exhibited inhibitory, bacteriostatic effects on M. ulcerans growth in vitro. After establishing an ulcerative M. ulcerans infection for three months, ulcerated regions of the tails were treated once daily (five consecutive days per week) for 22 days with hydrated CB09 clay poultices. Mice in the clay treatment group exhibited healing as assessed by gross morphological changes and a reduction in M. ulcerans present in the wounds.
These data reveal that specific clays exhibit in vitro bactericidal activity against M. ulcerans and that hydrated clay poultices may offer a complementary and integrative strategy for topically treating Buruli ulcer disease.
Source : BMC Complementary and Alternative Medicine
Link to Full Article
Effect of Tualang honey on the anastomotic wound healing in large bowel anastomosis in rats-A randomized controlled trial
- Muhammad Izani Aznan†,
- Omaid Hayat Khan,
- Allah Obhayo Unar†,
- Sharifah Emilia Tuan Sharif,
- Amer Hayat Khan,
- Syed Hassan Syed Abd. Aziz and
- Andee Dzulkarnaen Zakaria†
Honey has long been used for the treatment of number of ailments and diseases including surgical wounds. Current study evaluates the effectiveness of Tualang honey (TH) for large bowel anastomotic healing in Wistar rats.
Thirty male Wistar rats were given a 3 centimeter infra-umbilical laparotomy wound, in`flicted on their abdomen. The colonic transection was performed at 5 cm distal to caecum, with end to end anastomosis of colon segment. They were divided into two groups. Group I was fed with standard rat chow and water. Meanwhile, Group II apart from standard feed, was also given TH 1.0 g/kg every morning until day seven post operatively. Afterwards, anastomotic bursting pressures were measured and histopathological examination on the anastomosis line was performed with light microscopes. The data from two groups were analyzed by Independent paired t test for continuous variables.
It was found that the tensile strength of colon anastomosis (95 % CI; p = <0.001) and the histopathological study including fibroblast count (p = <0.001) and inflammatory cells (p = 0.002) showed statistically significant difference in the favor of TH-treated group. Meanwhile, neovascularization formation was not statistically significant (p = 0.807); however, the overall count in the TH group was high.
Oral treatment with TH enhances anastomotic wound healing by increasing the number of fibroblasts and by decreasing inflammatory cells leading towards increased wound strength.
Source : BMC Complementary and Alternative Medicine
Link to Full Article
Grape Seed Extract Cream Promotes Surgical Wound Healing
Hemmati AA, Foroozan M, Houshmand G, Moosavi ZB, Bahadoram M, Maram NS.
The topical effect of grape seed extract 2% cream on surgery wound healing. Glob J Health Sci. 2015;7(3):52-58.
Wound healing can be affected by factors such as age, medications, nutrition, circulation and tissue hypoxia status, and use of localized antibiotics and antiseptics. Accelerated wound healing reduces the risk for infection, lowers the number of complications, and decreases costs. Studies suggest that using plant resources alone or combined with chemical agents promotes more effective wound healing. Grape (Vitis vinifera, Vitaceae) seed extract has been found to possess antioxidant, antimicrobial, antiviral, and antibacterial activities, which may help wound healing. The goal of this double-blind, clinical study was to investigate the effects of grape seed extract on the healing of small surgical wounds in humans.
The 3-week study enrolled patients admitted to the Dermatology Clinic at Imam Khumeini Hospital at the Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran, for surgery on skin lesions. The patients were aged between 14 and 50 years, with benign skin lesions measuring between 3 mm and 1 cm. The lesions included skin tags and moles on the neck, trunk, and limbs. Both groups were similar in demographic data, skin type, clinical diagnosis of lesion, and lesion location and size. Patients were excluded if they had underlying diseases, were taking immunosuppressants, were pregnant, or had accompanying malignancy.
Forty patients were randomly assigned to use grape seed 2% cream (n=20) or placebo cream (n=20) topically. The topical grape seed cream was produced by the Faculty of Pharmacy at the university where the study was conducted. Grape seed 2% cream was based on Eucerin®; its aqueous phase was greater than its fat phase (about 60%). Also in the cream were preservatives and specific compounds for color and flavor (details not provided). The placebo cream contained the same ingredients, except for the grape seed extract.
All lesions were surgically removed with scalpel and/or surgical scissors after the skin was numbed with lidocaine and sterilized with Betadine®. They were then treated with the secondary intention method. After bleeding had stopped, the lesion was measured, cream was applied on the wound, and the wound was dressed.
Patients were instructed to wash their hands and wound and then apply the cream on the surface of the wound twice daily, completely covering the wound area, for 21 days. At day 1, wound level was considered 100% and rate of improvement, 0%. The patients were visited on days 3, 7, 10, 14, and 21. At each visit, the surface area of the wound was measured, the shape of the lesion graphed, each wound photographed, and wound level and rate of improvement recorded. Two patients from the grape seed group and 3 from the placebo group withdrew from the study, leaving 35 patients whose data were analyzed at the end of the study.
Wound healing was significantly better in the grape seed group compared with the placebo group at day 3 (P=0.0001), day 7 (P=0.0001), day 10 (P=0.0001), and day 14 (P=0.036). Of the total number of lesions (1-2 per patient), 31 were examined in the grape seed group and 32 in the placebo group. On day 3, none of the lesions were completely healed; however, the mean level of healing in the grape seed group was 79.44% compared with 55.5% in the placebo group.
On day 7, none of the lesions in the placebo group had healed; 20 (64.5%) lesions in the grape seed group were fully healed (P=0.0001). On day 10, 9 (28.2%) lesions in the placebo group (28.2%) displayed complete healing, compared with complete healing of all 31 lesions in the grape seed group (P=0.0001). Levels of healing were 95.48% in the placebo group and 100% in the grape seed group. By day 21, all lesions in the placebo group had healed. The groups' mean healing times were 8 days (grape seed) versus 14.4 days (placebo).
The authors conclude that this study shows that topical use of grape seed extract cream can be effectively used to promote wound healing. They suggest its effectiveness may be due to its proanthocyanidins and additional antioxidant properties, which "trigger the release of vascular endothelial growth factor along with the promotion of fibroblasts to produce more collagen fibres," causing wound closure. Wound healing may also be aided by the extract's anti-inflammatory and antimicrobial properties.
A drawback of this study is the poor characterization of the grape seed extract used. In general, the composition of grape seed extracts is critically dependent on the protocol of extraction and purification used. This reflects in a very different distribution of proanthocyanidins in terms of molecular weight.
Source : American Botanical Council
Link to Source
Skin Wound Healing and Phytomedicine: A Review
Pazyar N.a · Yaghoobi R.a · Rafiee E.a · Mehrabian A.a · Feily A.b
Skin integrity is restored by a physiological process aimed at repairing the damaged tissues. The healing process proceeds in four phases: hemostasis, inflammation, proliferation and remodeling. Phytomedicine presents remedies, which possess significant pharmacological effects. It is popular amongst the general population in regions all over the world. Phytotherapeutic agents have been largely used for cutaneous wound healing. These include Aloe vera, mimosa, grape vine, Echinacea, chamomile, ginseng, green tea, jojoba, tea tree oil, rosemary, lemon, soybean, comfrey, papaya, oat, garlic, ginkgo, olive oil and ocimum. Phytotherapy may open new avenues for therapeutic intervention on cutaneous wounds. This article provides a review of the common beneficial medicinal plants in the management of skin wounds with an attempt to explain their mechanisms.
Source : Skin Pharmacol Physiol
Link to Full Article
Selenium added unripe carica papaya pulp extracts enhance wound repair through TGF-β1 and VEGF-a signalling pathway
Abdulrazaq Bidemi Nafiu1 and Mohammad Tariqur Rahman2*
BackgroundIncreased wound healing efficiency by Se 2+ added Carica papaya L. (Caricaceae) fruit extract was linked to increased antioxidant and anti-inflammatory responses during healing.
We investigated the impact of Se 2+ or Zn 2+ added papaya water (WE) and phosphate-buffered saline (PE) extracts on cells recruitment and bio-molecular alterations on days 4 and 10 post wounding in an in vivo excision wound.
MethodsExcision wounds were created on the dorsum of Sprague Dawley rats and treated topically twice/day with 20 μL of PE and WE (5 mg extract/mL), 0.5 μgSe 2+ added PE and WE (PES and WES), or 100 μMZn 2+ added PE and WE (PEZ and WEZ). Deionised water (negative) and Solcoseryl (positive) were applied on the control groups. Histochemical and biochemical assays were used to evaluate cellular and bio-molecular changes in the wound.
ResultsPES (PE + 0.5 μg Se 2+ ) only increased significantly (p < 0.05) wound total protein content (95.14 ± 1.15 mg/g tissue vs positive control; 80.42 ± 0.86 mg/g tissue) on day 10 post wounding. PES increased significantly (p < 0.05) the number of fibroblasts/high power field (HPF) (75.60 ± 9.66) but decreased significantly (p < 0.05) the number of polymorphonuclear leukocytes/HPF (59.20 ± 12.64) in the wound compared to positive control (50.60 ± 12.58 fibroblasts/HPF, 101.00 ± 27.99 polymorphonuclear leukocytes/HPF) on day 4. Similar results were recorded for WES. PES demonstrated increased neovascularization, TGF-β1 and VEGFA expressions at day 4 and increased collagen at day 10.
ConclusionPapaya extract improved wound repair by increasing fibroblasts recruitment and reducing polymorphonuclear leukocytes infiltration through early transient expressions of TGF-β1 and VEGFA at the wound area. The processes were amplified with Se 2+ addition.
Source :BMC Complementary and Alternative Medicine
Link to Full Extract
Topical Hypericum perforatum Improves Tissue Regeneration in Full-Thickness Excisional Wounds in Diabetic Rat Model
Soheila Yadollah-Damavandi,1 Mehdi Chavoshi-Nejad,2 Ehsan Jangholi,1 Noushin Nekouyian,3 Sahar Hosseini,3 Amin Seifaee,3 Shima Rafiee,3 Hossein Karimi,3 Soheil Ashkani-Esfahani,3 Yekta Parsa,1 and Maryam Mohsenikia4
1Young Researchers and Elite Club, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran
2Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
4Dezful University of Medical Sciences, Dezful, Iran
Delayed wound healing process is one of the most important concerns in diabetes. Healing of wounds has four phases, namely, hemostasis, inflammation, proliferation, and remodeling. For a successful repair, all four factors must occur properly. Hence, we aimed to evaluate the healing effects of Hypericum perforatum (HP) on full-thickness diabetic skin wounds by using stereological methods. Forty-eight female diabetic rats were randomly divided into four groups (n = 12): gel base treated group, HP 5% gel treated group, HP 10% gel treated group, and the control group which received no treatment. A circular 1 cm2 full-thickness wound was created on the animal’s neck and wound area was measured every three days. After sacrificing the animals, skin samples were fixed and prepared for stereological evaluations. Based on the results, HP treated group showed faster wound closure rate in comparison with control and vehicle groups (P<0.05). In addition, numerical density of fibroblasts, volume density of collagen bundles, and mean diameter and volume densities of the vessels in HP group were significantly higher than control and vehicle groups. The results of this study showed that HP has the ability to improve tissue regeneration by enhancing fibroblast proliferation, collagen bundle synthesis, and revascularization.
Source : Evidence Based Complementaryand Alternative Medicine
Link to Full Article
Evaluation of the wound healing property of Commiphora guidottii Chiov. ex. Guid.
Michael Gebrehiwot1, Kaleab Asres1*, Daniel Bisrat1, Avijit Mazumder2, Peter Lindemann3and Franz Bucar4
The traditional use of the oleo-gum-resin of Commiphora guidottii Chiov. ex. Guid., which is commonly called scented myrrh, for topical treatment of wound is well documented. The major objective of the present study was to investigate the essential oil and resin obtained from C. guidottii for their potential wound healing properties. Due to their influence on the wound healing process, the anti-inflammatory and antimicrobial activities of scented myrrh have also been investigated.
Powdered oleo-gum-resin of C. guidottii was steam-distilled to obtain essential oil, and the resin was extracted from the marc with MeOH and filtered. The TLC fingerprint profile of the resin has been recorded by using silica gel GF 254 as stationary phase. The essential oil components were identified and quantified by GC-MS. Ointments prepared from the essential oil (4 % v/w) and the resin (5 % w/w) were used for wound healing activity tests. Toxicity of the formulated ointments was investigated according to Draize skin irritation test. Acute anti-inflammatory effect in mice was evaluated using carrageenan induced mouse hind paw oedema model. Antimicrobial activity tests were carried out using disk diffusion and broth dilution techniques against 21 pathogenic bacterial and 4 fungal strains.
Ointment formulations of both the oil and resin were found to be non-irritant at the concentrations used and showed significant (p < 0.05-0.001) increase in wound contraction rate, shorter epithelization time and higher skin breaking strength as compared to the negative control. Overall, the antibacterial and antifungal activities of the oil and resin were comparable with the standard antibiotics ciprofloxacin and griseofulvin, respectively.
The results confirm that scented myrrh possesses genuine wound healing activity supporting the traditional use of the plant.
Source : BMC Complementary and Alternative Medicine
Link to Full Article
In Vitro Anti-Inflammatory and Wound-Healing Potential of a Phyllostachys edulis Leaf Extract – Identification of Isoorientin as an Active Compound
Jonas Wedler1, Tony Daubitz1, Götz Schlotterbeck2, Veronika Butterweck1
Extracts prepared from the leaves of Phyllostachys edulis (bamboo) have received attention in pharmacological research due to their potent antitumor, anti-inflammatory, antimicrobial, and anti-ulcerogenic activities. In this study, anti-inflammatory effects of a bamboo leaf extract on tumor necrosis factor alpha-induced overproduction of interleukin 8, vascular endothelial growth factor, and interleukin 6 in immortalized human keratinocytes were investigated for the first time. In addition, wound-healing effects were evaluated in 3T3-swiss albino mouse fibroblasts. Bamboo leaf extract and isoorientin inhibited the tumor necrosis factor alpha-induced release of interleukin 8 and vascular endothelial growth factor. Furthermore, isoorientin dose-dependently reduced levels of interleukin 6 in tumor necrosis factor alpha-α-treated immortalized human keratinocytes cells. Wound healing was evaluated using a modification of the classical scratch assay. For evaluation of the wound gap, a new computerized method based on time-lapse microscopy was developed. It was shown that bamboo leaf extract (10 µg/mL) improved wound closure by 28 % (12 h) and 54 % (24 h), respectively. In concentrations of 50 µg/mL and above, bamboo leaf extract inhibited cell migration without affecting cell viability. Isoorientin (10 µM) improved wound closure by 29 % (12 h) and 56 % (24 h), respectively. Comparable to bamboo leaf extract, higher concentrations of isoorientin prevented cell migration. It is suggested that bamboo leaf extract as well as isoorientin have a dual activity – in higher doses, they show anti-inflammatory effects, and in lower concentrations, they exert anti-angiogenic activities.
In conclusion, natural accelerators of cutaneous tissue repair with simultaneous anti-inflammatory activities are of great interest for a variety of dermatological disorders. Thus, treatment with P. edulis leaf extract or isoorientin may be a potential therapeutic strategy to promote wound healing and to prevent inflammation in a persistent inflammatory condition. Further investigations of the precise mechanism by which P. edulis and isoorientin reveal anti-inflammatory as well as wound-healing properties are currently underway.
Source : Planta Medica
Link to Full Article
Cinnamon Ointment Reduces Pain and Promotes Wound Healing After Episiotomy
by Shari Henson
Mohammadi A, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, Javadzadeh Y, Fardiazar Z, Effati-Daryani F. Effects of cinnamon on perineal pain and healing of episiotomy: a randomized placebo-controlled trial. J Integr Med. 2014;12(4):359-366.
Episiotomy, a common obstetric intervention during which an incision is made to enlarge the vaginal opening during childbirth, is often accompanied by perineal pain in the immediate postpartum period that can affect child care and other responsibilities. Episiotomy treatments include nonsteroidal anti-inflammatory drugs for pain and Betadine® (Purdue Pharma L.P.; Stamford, Connecticut) for wound healing (although Betadine is no longer used frequently in the United States for postnatal perineal care). For some women, those therapies are unsatisfactory; instead, they seek more effective, safer options. Cinnamon (Cinnamomum spp., Lauraceae) bark’s essential oil and ethanolic extract preparations exhibit numerous beneficial properties, including anti-inflammatory, antioxidant, and antimicrobial activities1; however, no human studies have been conducted on its analgesic and healing effects. These authors conducted a randomized, double-blind, placebo-controlled trial to determine the effects of a cinnamon extract ointment on episiotomy wounds.
Women aged 18 to 40 years who had given birth vaginally with episiotomy were recruited in Tabriz, Iran, at two hospitals affiliated with Tabriz University of Medical Sciences (Alzahra and Taleghani Hospitals) and at one hospital affiliated with the Iranian Social Security Organization. In these hospitals, 90% of women undergo episiotomies during their first vaginal delivery and 70% during their second and third deliveries. (One reviewer of this article noted that such high percentages of women undergoing episiotomies in these hospitals represents “irresponsible and outdated medical care.” In 2005, episiotomies for vaginal births were performed on only 30 to 35% of women in the United States.2) The authors recruited 144 patients (mean age: 26.4 ± 4.9 years) from February 20, 2013 to October 31, 2013; follow-up ended on November 11, 2013. While in the hospital, the patients completed a questionnaire on socio-demographic and reproductive characteristics. Each patient’s episiotomy incision was measured, and a baseline of perineal pain and wound healing was assessed.
The authors randomly assigned 72 patients to the cinnamon ointment group or the placebo group, both of which were similar in terms of socio-demographic and reproductive characteristics. For more than half of the women in each group, the delivery was their first. The patients were instructed on how to apply the ointment to the episiotomy wound twice daily every 12 hours for 10 days.
The hydroalcoholic cinnamon bark extract ointment (2% by weight; prepared at the Industrial Pharmacy Laboratory at the Tabriz University of Medical Sciences) contained cinnamon, methyl paraben, propyl paraben, and Eucerin® (a dermatological cream for dryness, itching, etc.; Beiersdorf AG; Hamburg, Germany). Prepared at the same laboratory and placed in tubes identical in color, shape, and size, the placebo ointment contained the same ingredients except for the cinnamon extract.
For pain relief, 10 mefenamic acid capsules (400 mg) were administered to each patient. The patients were given a diary to record ointment use, analgesics taken, and any adverse side effects, and they were instructed to return to the hospital with their empty ointment tubes after 10 to 11 days for reassessment.
Primary outcomes were assessed as follows: Perineal pain was measured by visual analogue scale (VAS) and recorded at baseline (one hour after episiotomy repair), four (±1), and eight (±1) hours after the first treatment with the ointment, and at 10 to 11 days after delivery. Wound healing was assessed at baseline, eight (±1) hours after first applying the ointment, and at 10 to 11 days after delivery by using the Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) scale. Secondary outcomes included components of REEDA, the number of analgesics taken during the trial, the resumption of normal daily activities within five days postpartum, and adverse side effects. At 10 to 11 days postpartum, 62 patients in the cinnamon group and 61 in the placebo group remained in the trial for final analysis.
At baseline, the mean pain intensity was 5.0 ± 1.8 in the cinnamon group and 4.6 ± 2.0 in the placebo group. Pain intensity in the cinnamon group was significantly lower than in the placebo group after four hours (mean difference [MD]: -0.6; 95% confidence interval [CI]: -1.0 to -0.2); after eight hours (MD: -0.9; CI: -1.4 to -0.3); and after 10 to 11 days (MD: -1.4; CI: -2.0 to -0.7). Compared with baseline values, pain intensity reduced by 16% at four hours, by 26% at eight hours, and by 76% at days 10-11 in the cinnamon group; the placebo group had pain intensity reductions of 2% at four hours, 4% at eight hours, and 43% at days 10-11. REEDA healing scores were significantly lower in the cinnamon group than in the control group at eight hours (MD: -0.2; CI: -0.4 to -0.04) and at days 10-11 after delivery (MD: -1.6; CI: -2.0 to -1.1). Compared with baseline, REEDA scores were 53% lower in the cinnamon group and 6% lower in the placebo group at days 10-11. Overall, both pain intensity and healing scores were significantly lower after cinnamon ointment intervention compared with placebo ointment intervention (P<0.01).
Evaluation of secondary outcomes revealed no significant between-group differences in the REEDA components at baseline and after eight hours, except for improved scores for wound approximation in the cinnamon group (P=0.02). Compared with baseline scores, wound healing scores in the cinnamon group improved significantly more than in the placebo group in four of five components (P<0.01 for redness and edema, P=0.021 for ecchymosis, and P=0.003 for approximation). At days 10-11 postpartum, no significant between-group differences were noted in the number of mefenamic acid capsules or other analgesics taken.
The number of patients resuming their normal daily activities within five days postpartum was significantly higher (P=0.003) in the cinnamon group (46 women; 74%) than in the placebo group (29 women; 48%). No adverse side effects were reported in either group.
Cinnamon bark’s three main compounds are eugenol, cinnamaldehyde, and linalool. According to the authors, eugenol, which has a topical numbing effect, may affect inflammation by reducing prostaglandin biosynthesis. Cinnamaldehyde also has anti-inflammatory properties,3 and linalool possesses analgesic and anti-inflammatory properties that work by reducing nitric oxide and activating analgesic paths of cholinergic and glutamatergic compounds.4,5 The cinnamon polyphenols may also reduce inflammation.6
The authors conclude: “Our study results showed that use of cinnamon ointment on episiotomy incision for 10 d[ays] reduced intensity of perineal pain and improved healing of the incision with no significant side effects.”
1. Jakhetia V, Patel R, Khatri P, et al. Cinnamon: a pharmacological review. J Adv Sci Res. 2010;1(2):19-23.
2. Hartmann K, Viswanathan M, Palmieri R, Gartlehner G, Thorp J, Lohr KN. Outcomes of routine episiotomy: a systematic Review. JAMA. 2005;293(17):2141-2148.
3. Zarifkar A, Skandaryan HMS, Mokhtary M, Ay J. An evaluation on antinociceptive effects of eugenol by formalin test in rats. [Persian with abstract in English.] J Dental Medicine. 2003;16(1):61-67.
4. Peana AT, Marzocco S, Popolo A, Pinto A. (–)-Linalool inhibits in vitro NO formation: probable involvement in the antinociceptive activity of this monoterpene compound. Life Sci. 2006;78(7):719-723.
5. Peana AT, D’Aquila PS, Chessa ML, Moretti MD, Serra G, Pippia P. (–)-Linalool produces antinociception in two experimental models of pain. Eur J Pharmacol. 2003;460(1):37-41.
6. Hong JW, Yang GE, Kim YB, Eom SH, Lew JH, Kang H. Anti-inflammatory activity of Cinnamon water extract in vivo and in vitro LPS-induced models. BMC Complement Altern Med. 2012;12:237. doi: 10.1186/1472-6882-12-237
Source : .HerbalGram. 2014; American Botanical Council
Link to Source
Topical Application of Cleome viscosa Increases the Expression of Basic Fibroblast Growth Factor and Type III Collagen in Rat Cutaneous Wound
Aadesh Upadhyay,1,2 Pronobesh Chattopadhyay,1 Danswrang Goyary,1 Papiya M. Mazumder,2 and Vijay Veer1
1Division of Pharmaceutical Technology, Defence Research Laboratory, Tezpur, Assam 784001, India
2Department of Pharmaceutical Sciences, Birla Institute of Technology, Mesra, Ranchi, Jharkhand 835215, India
Cleome viscosa L. (Cleomaceae) is an important traditional medicine of the Indian-Ayurvedic and Chinese-medicine system documented for rheumatic arthritis, hypertension, malaria, neurasthenia, and wound healing. The plant is also known as Asian spider flower and is distributed throughout the greater part of India. The present study explored the wound healing property of C. viscosa methanol extract (CvME) and its related mechanism using Wistar rat cutaneous excision wound model. Wound contraction rate, hydroxyproline quantification, and histopathological examination of wound granulation tissue were performed. The healing potential was comparatively assessed with a reference gentamicin sulfate hydrogel (0.01% w/w). Western blot for COL3A1, bFGF, and Smad-2, Smad-3, Smad-4, and Smad-7 was performed with 7-day postoperative granulation tissue. Results revealed that the topical application of CvME (2.5% w/w) significantly accelerated the wound contraction rate (95.14%, 24 postoperative days), increased the hydroxyproline content (3.947 mg/100 mg tissue), and improved histopathology of wound tissue as compared to control groups. Western blot analysis revealed that CvME significantly upregulated the expression of COL3A1 and bFGF and increased the Smad-mediated collagen production in granulation tissue. These findings suggest that C. viscosa promoted the wound repair process by attenuating the Smad-mediated collagen production in wound granulation tissue.
Source : Biomed Research International
Link to Full Article
Antitumor and Wound Healing Properties of Rubus ellipticus Smith.
Blassan Plackal George, Thangaraj Parimelazhaga, Yamini T. Kumar, Thankarajan Sajeesh
The present investigation has been undertaken to study the antioxidant, antitumor, and wound healing properties of Rubus ellipticus. The R. ellipticus leaves were extracted using organic solvents in Soxhlet and were subjected to in vitro antioxidant assays. R. ellipticus leaf methanol (RELM) extract, which showed higher in vitro antioxidant activity, was taken for the evaluation of in vivo antioxidant, antitumor, and wound healing properties. Acute oral and dermal toxicity studies showed the safety of RELM up to a dose of 2 g/kg. A significant wound healing property was observed in incision, excision, and Staphylococcus aureus-induced infected wound models in the treatment groups compared to the control group. A complete epithelialization period was noticed during the 13th day and the 19th day. A 250-mg/kg treatment was found to prolong the life span of mice with Ehrlich ascite carcinoma (EAC; 46.76%) and to reduce the volume of Dalton's lymphoma ascite (DLA) solid tumors (2.56 cm3). The present study suggests that R. ellipticus is a valuable natural antioxidant and that it is immensely effective for treating skin diseases, wounds, and tumors.
Source : Journal of Acupuncture and Meridian Studies
Link to Full Article
Medicinal Honey Improves Wound Healing, Decreases Pain
Floral honey as a secondary dressing can promote healing, minimize slough and necrosis, and reduce the affected area of many types of wounds, according to a prospective observational study published online April 12 in International Wound Journal. Of all the wounds in a study population of European patients who received topical honey as an adjunct to other dressings, 31.4% completely healed and 53.3% improved during an observational period of several weeks, reported Bahram Biglari, MD, from the Department of Paraplegia and Technical Orthopedics, Insurance Association Trauma Centre, Ludwigshafen, Germany, and colleagues. Stagnation occurred in 9.2% of the group's wounds, and 6.1% of the wounds worsened.
Measured as an average total wound surface area for all patients, wound size decreased significantly during the study period, from 29.66 ± 57.57 cm2 (P < 0.05; 2-tailed t-test). Honey dressings also demonstrated a measurable effect on wound cleanliness and patient-reported pain levels.
The study, which received financial support from a manufacturer of Medihoney, lends additional credence to earlier investigations that focused on honey-assisted autolysis and wound debridement.
"I commend Biglari et al in this timely, multicenter study for the treatment of diverse wounds with Medihoney. Obviously, the effect of decreased wound size…demonstrates the effectiveness of honey," wrote Sammy Sinno, MD, from the Institute of Plastic and Reconstructive Surgery at New York University, in an email interview with Medscape Medical News. "This study was a clear demonstration of the effectiveness of honey, particularly Medihoney, in treating wounds."
Dr. Sinno is one of the coauthors of a review article on honey and wound healing that appeared in the American Journal of Clinical Dermatology (2011;12:181-190). He was not involved in Dr. Biglari and colleagues' research.
Researchers enrolled patients treated at 10 medical institutions in Germany and Austria between March 2007 and March 2009. The causes of 154 wounds in the 121-patient study group included general and postoperative wounds, pressure ulcers, soft tissue infections, burns, scalds, and skin lesions. Seventeen patients dropped out, leaving 104 to be included in the treatment assessment. Almost half the participants were younger than 18 years, and nearly one third (32%) were oncology patients.
Investigators applied antibacterial Medihoney alone in 66% of the treatments. In another 22% of cases they used antibacterial Medihoney wound gel, which is composed of 80% honey and 20% plant emollients. They used a combination of both products in 6% of the wounds. In the remainder of the cases they applied honey secondarily to other dressings, including calcium alginate, hydrofiber dressings, and sterile gauzes moistened with isotonic sodium chloride solution.
Investigators changed dressings after 1 to 3 days if they observed wound exudation. They protected wound margins when necessary and cleaned the wounds with sterile solution. The investigators assessed each patient's wounds at least 3 times over observational periods averaging just under 5 weeks.
High tolerance of topical honey was reflected in 89% of the wound assessments.
Wounds were rated as "clean" (grade 1, no slough or necrosis) or "not clean" (grade 0, slough and/or necrosis present). After the application of honey dressings, wound cleanliness improved significantly, from an average grade of 0.16 ± 0.37 to 0.74 ± 0.44 (P < .05; paired Student's t-test).
To assess pain, investigators asked patients to grade the discomfort they felt on a scale of 0 to 10. The total average pain scores reported between recruitment and the end of the observation period decreased significantly, from 1.71 ± 1.89 to 0.55 ± 1.22 (P < .05; paired Student's t-test).
Yet the authors cautioned that "the extent of pain reduction that can be attributed to honey is difficult to evaluate from a non-controlled observational study. A comparative trial with other dressings or remedies would be more conclusive in this regard."
Floral honey drawn from Leptospermum scoparium (manuka) has been shown in many case studies to accelerate healing. And numerous studies have focused on its antimicrobial benefits, especially with regard to antibiotic-resistant bacteria, such as Staphylococcus aureus. The current investigation, however, did not focus on the antibacterial effects of applied honey because physicians had already committed to the use of local antiseptics or systemic antibiotics for conditions afflicting many of the study's participants.
According to Dr. Sinno, Medihoney is one of several honey products that are Food and Drug Administration–approved for wound healing. "I believe [Medihoney] is a safe and efficacious product for the treatment of pressure ulcers and lower extremity ulcers (venous, arterial, and diabetic)," Dr. Sinno wrote. "Although the data is limited, honey also has promise in other wounds including Fournier gangrene, pyoderma gangrenosum, infected surgical wounds, burn and traumatic wounds."
But Dr. Sinno acknowledged that the use of honey for wound healing has not yet reached the mainstream. "Despite a growing number of clinical trials such as the one by Biglari et al, medicinal honey is still not familiar to many wound care practitioners. Based on this study and many others reviews in our review paper…this skepticism is certainly not justified. I think larger, randomized controlled trials in major wound centers across the country would be needed to once and for all put to rest the skepticism surrounding this age-old remedy and help honey find a place in the physician's armamentarium for treating wounds."
Source : Medscape via International Wound Jrnl (Multicentre prospective observational study on professional wound care using honey (Medihoney™)
Link to Source