Wound Healing: Contributions from Medicinal Plants and Their Phytoconstituents

Wound is an inescapable condition in one’s lifetime that may arise due to physical injuries that can result in an opening or break of skin or chemical means. Wounds represent a significant burden on patients and can affect the physical and mental health of millions of patients thereby imposing a significant cost on them. Wounds are major cause of physical disabilities. The wound area is an ideal medium for the manipulation of many infecting organisms. The injured skin, therefore, remains vulnerable to invasive microbial infections. The primary objective of wound care, therefore, is to prevent or minimize infection and promote healing. Various materials and methods, especially antibacterial drugs are employed. Some of these wound care methods employed include the topical antimicrobial therapy of plant extracts. The present article, therefore, focuses on the review of the role medicinal plants play in wound healing with special attention on plants that have demonstrated both wound healing and antioxidant properties. Further attention was given to isolated compounds from wound healing plants that exhibited wound healing properties.

Effects of Coriaria Sinica Maxim's extract on microcirculation and oxidative stress of wounds in rats with deep second-degree burn / 中国应用生理学杂志

OBJECTIVE@#To investigate the effects of Coriaria Sinica Maxim's extract(CSME) on microcirculation and oxidative stress of wounds in rats with deep second-degree burn.@*METHODS@#One hundred and eighty rats were randomly divided into normal saline group(NS), white petroleum group(WPL), silver sulfadiazine group (SSD), Coriariasinica Maxim's extract group which were divided into low dose(CSME-L),middle dose(CSME-M) and high dose(CSME-H). After anesthesia with burn instrument to burn the hair removal area of rats, these wounds were confirmed by pathological results with deep second degree burns.And then,those drugs were applied respectively on the wounds,such as NS、WPL、SSD and different concentrations of CSME. After injury at 48 h, 7 d, 14 d and 21 d,the healing rate(HR) of wound was measured, and the microvessel density (MVD), tissue moisture (TM), vascular endothelial growth factor (VEGF), model driven architecture (MDA), superoxide dismutase(SOD) and hydroxyproline(HYP) were detected, too. All pathological sections of the wound tissue were observed.@*RESULTS@#The HR of CSME groups were obviously increased with a dose-dependent manner, which was significantly higher than that of NS and WPL (<0.05); On the 21 day, the diameter, number, distribution of the vessels and and the TM were less than other groups with a dose-dependent manner; On the 7 and 14 day after injury, CSME groups were significantly higher than the NS, WPL and SSD with a dose-dependent manner (<0.05), but, on the 21 day after injury, they were lower than NS, WPL and SSD with a dose-dependent (<0.05) manner. The levels of SOD, HYP, NO and ET in CSME groups were higher than those in other groups with dose-dependent on SOD activity, HYP, NO and ET content (<0.05), while MDA activity was weaker than other groups (<0.05). Similarly, pathological findings were also shown that CSME groups were better than other groups with a dose-dependent manner in decrease decreasing of wound repair time and hyperplasia of scar tissue.@*CONCLUSIONS@#CSME can relieve tissue edema, promote wound contraction, speed up the formation of eschar and accelerate the proliferation of granulation tissue, which are beneficial to the wound healing in the early stages. But, it can inhibit the hyperplasia of granulation tissue to prevent the excessive scar hyperplasia of burn wound in the later stages. Its mechanism is related to regulation what microcirculation, oxidativestress, NO and VEGF.

Therapeutic Observation of Moxa Smoke Fumigation in Healing Wounds and Releasing Pain After Perianal Abscess Surgery / 上海针灸杂志

Objective To observe the therapeutic efficacy of moxa smoke fumigation in promoting the wounds healing and improving the pain at dressing changes after perianal abscess surgery.Method A hundred eligible patients with perianal abscess were divided into a treatment group and a control group by the random number table, 50 cases in each group. The subjects all received dressing change from nurses of the Anorectal Department. In addition, the treatment group received moxa smoke fumigation at wounds for 30 min and the control group received microwave radiation at wounds for 30 min, both after dressing change, for a total of 14 times. The wounds-healed time, Visual Analogue Scale (VAS) scores on the day 1, 2, 3, 7, and 14 after the surgery, and Verbal Rating Scale (VRS) scores of the two groups were observed.ResultPatients in the treatment group took significantly shorter time to heal the wounds compared to those in the control group (P0.05), while the scores in the treatment group on day 2, 3, 7 and 14 were significantly lower than those in the control group (P<0.05); the VRS scores on day 1, 2, 3, 7, and 14 in the treatmentgroup were significantly lower than those in the control group (P<0.05).Conclusion Moxa smoke fumigation can promote the healing of the wounds after perianal abscess surgery, reduce the pain brought by dressing change, and this analgesic effect is consistent.

Açúcar granulado ou em gel no tratamento de feridas em cães / Granulated sugar and sugar gel in treating canine wounds

O açúcar é um dos produtos mais utilizados para tratamento de feridas em medicina veterinária. Sua principal vantagem é o efeito higroscópico nos tecidos e morte das bactérias por plasmólise, tornando-o um bactericida pelo efeito físico realizado, sem levar à resistência bacteriana. O objetivo deste experimento foi comparar a evolução cicatricial de feridas cutâneas com o uso tópico de açúcar na forma granulada e na forma de gel. Foram tratadas 16 feridas de cães, das quais oito receberam tratamento com açúcar granulado (grupo A) e oito com gel de açúcar (grupo G). O tempo de tratamento, independente do grupo, levou, no mínimo, sete dias e, no máximo, 14. Quanto à aplicabilidade, o gel demonstrou melhor adesão nas feridas e preenchimento do produto no subcutâneo de forma mais efetiva que o açúcar granulado. Conclui-se que tanto o gel quanto o açúcar foram efetivos na cicatrização das feridas dos animais deste experimento, sendo que o gel demonstrou precocidade na retração cicatricial nos primeiros sete dias.

Sugar is one of the most widely used products in the treatment of wounds in veterinary medicine. Its main advantage is the hygroscopic effect on tissues and the bacterial death by plasmolysis, making it a bactericidal agent due to the physical effect observed, without leading to bacterial resistance. The aim of this experiment was to compare cicatricial evolution of cutaneous wounds with the topical use of sugar either granulated or as gel. Sixteen canine wounds were treated: eight with granulated sugar (group A) and eight with sugar gel (group G). Treatment time, independent of the group, took at least seven days and a maximum of 14. Concerning applicability, gel sugar showed better adhesion to wounds and subcutaneous filling more effectively that granulated sugar. It is concluded that both granulated and gel sugar were effective in healing skin wounds, the gel being precocious in cicatricial retraction within the first seven days of treatment.

Evaluación de la terapia larval en el proceso de curación de heridas infectadas con Pseudomonas aeruginosa en conejos / Evaluation of the larval therapy in the healing process of infected wounds with Pseudomonas aeruginosa in rabbits

Introducción. Durante las últimas dos décadas, la terapia larval ha resurgido como una alternativa confiable y segura para la cura de úlceras cutáneas que no responden a los tratamientos convencionales. Objetivo. Evaluar el uso de las larvas de Lucilia sericata en el tratamiento de heridas infectadas con Pseudomonas aeruginosa en un modelo animal. Materiales y métodos. Se tomaron 12 conejos, los cuales fueron divididos al azar en 3 grupos homogéneos: al primero se le aplicó terapia larval, el segundo se trató con terapia antibiótica y el tercero fue establecido como control. A cada uno de los animales se les realizó una herida, luego se inoculó en ésta una suspensión de P. aeruginosa y, finalmente, al registrarse el desarrollo de la infección, se procedió, en los dos primeros grupos, a los tratamientos correspondientes. Para la evaluación macroscópica de las heridas, se tuvo en cuenta la presencia de edema y exudado, mal olor, inflamación alrededor de la herida y apariencia del tejido de granulación. Al proceso de cicatrización se le hizo seguimiento a través de una técnica dermohistológica. Resultados. Se registraron claras diferencias entre el grupo de animales tratados con terapia larval vs. el grupo tratado con terapia convencional de antibióticos, estableciéndose un periodo de 10 días para alcanzar la cicatrización en el grupo de terapia larval mientras que en el segundo grupo el proceso se cumplió en 20 días. Conclusiones. S e demostró la eficacia de las larvas de L. sericata en el tratamiento de heridas infectadas con P. aeruginosa.

Introduction. During the last two decades the larval therapy has reemerged as a safe and reliable alternative for the healing of cutaneous ulcers that do not respond to the conventional treatments. Objective. To evaluate the use of the larvae of Lucilia sericata as a treatment for infected wounds with Pseudomonas aeruginosa in an animal model. Materials and methods. Twelve rabbits were randomly distributed in 3 groups: the first group was treated with larval therapy; the second was treated with antibiotics therapy and to the third no treatment was applied, therefore was established as a control group. To each animal a wound was artificially induced, and then a suspension of P. aeruginosa was inoculated into the lesion. Finally, every rabbit was evaluated until the infection development was recognized and treatment was set up for the first two groups according with the protocols mentioned above. Macroscopic evaluation of the wounds was based on the presence of edema, exudates, bad odor, inflammation around the wound and the presence of granulation tissue. The healing process was evaluated by monitoring histological changes in the dermal tissue. Results. Differences in the time required for wound healing were observed between the first group treated with larval therapy (10 days) and the second group treated with conventional antibiotics therapy (20 days). Conclusion. The L. sericata larva is and efficient tool as a therapy for infected wounds with P. aeruginosa.

Enfermeiro no cuidado do paciente com úlcera de pé diabético / Nurses caring for patients with diabetic foot ulcers / Enfermero en el cuidado de paciente diabético con úlcera de pie

O estudo teve como objetivo investigar a atuação do enfermeiro no cuidado do paciente com pé diabético no contexto ambulatorial. Foi realizado em ambulatório da rede pública na cidade de Fortaleza, Ceará, nos meses de agosto e setembro de 2003. A população constituída por 15 enfermeiras teve como amostragem 7 delas. Os dados foram obtidos por questionário e observação livre. Os resultados apresentados descritivamente e analisados segundo a literatura pertinente, mostraram que as enfermeiras realizam a avaliação e identificação do pé diabético por meio de teste de sensibilidade, exame dos pulsos e classificação da ferida. Posteriormente, realizam desbridamento e troca de curativos, utilizando solução fisiológica. As orientações realizadas dizem respeito ao controle da glicemia, higiene e hidratação dos pés. Conclui-se que a maioria dos cuidados são realizados conforme recomendação da literatura, sendo estes não restritos ao tratamento da ferida, havendo relação com a doença diabética.

The objective of the study was to investigate the performance of the nurse caring for patients with diabetic foot ulcers within the context of the day clinic. The study took place in a clinic of the public system of the city of Fotraleza, Ceara, in august and September, 2003. Out of the total number of 15 nurses, seven of them participated in the study. The data were collected through questionnaires and open observations. The results presented descriptively and analyzed based on pertinent literature reviews, illustrate that nurses perform the evaluation and identification of the diabetic foot using sensibility tests, pulse examinations, and classifications of the wound. Afterward, they proceed with debridement and changing of the bandages, utilizing a physiological solution. The procedures carried out are concerned with the control of glycemia, hygiene, and proper hydration of the feet. It is concluded that most of the treatments are performed according to literature recommendations, not only restricted to the treatment of the wound, but also relating to the diabetic disease.

El estudio tuvo como objetivo investigar la actuación del enfermero en el cuidado del paciente con pie diabético en el contexto del ambulatorio. Fue realizado en un ambulatorio de la red pública en la ciudad de Fortaleza, Ceará, en los meses de agosto a septiembre de 2003. La población constituida por 15 enfermeras tuvo como muestra a 07 de ellas. Los datos fueron obtenido mediante cuestionario y observación libre. Los resultados presentados descriptivamente y analizados según la literatura pertinente, mostraron que las enfermeras realizan la avaliación e identificación del pie diabético a través de un test de sensibilidad, examen de los pulsos y clasificación de la herida. Posteriormente, realizan el desbridamiento y el cambio de curativos, utilizando solución fisiológica. Las orientaciones realizadas se refieren al control de la glicemia, higiene e hidratación de los pies. Se concluye que la mayoría de los cuidados son realizados de acuerdo conforme a la recomendación de la literatura, los cuales no se restringen al tratamiento de la herida pues tienen relación con la enfermedad diabética.