NATURAL REMEDIES FOR WOUND HEALING: A LITERARY REVIEW

Abstract

A wound may be defined as a break in the epithelial integrity of the skin or may also be defined as a loss or contravention of cellular and anatomic or functional permanence of living tissue. Wound healing is the process of repair that follows injury to the skin and proper healing of wounds is crucial for the re-establishment of disrupted anatomical continuity and disturbed functional status of the skin. The phyto-medicines for wound healing are not only economical and inexpensive but are also supposedly safe as hyper sensitive reactions are rarely encountered with the use of these agents. Many plants have proved to possess momentous healing properties in poles apart from type of wounds. Nature has best owed on us a very rich botanical wealth and a large number of diverse types of plants grow in different parts of the country. This review examine about wound healing prospective of plants, its family, part used, extract used, model used and references which are supportive for researchers for expansion of novel wound healing formulation. [PUBLICATION ABSTRACT]

Headnote

ABSTRACT

A wound may be defined as a break in the epithelial integrity of the skin or may also be defined as a loss or contravention of cellular and anatomic or functional permanence of living tissue. Wound healing is the process of repair that follows injury to the skin and proper healing of wounds is crucial for the re-establishment of disrupted anatomical continuity and disturbed functional status of the skin. The phyto-medicines for wound healing are not only economical and inexpensive but are also supposedly safe as hyper sensitive reactions are rarely encountered with the use of these agents. Many plants have proved to possess momentous healing properties in poles apart from type of wounds. Nature has best owed on us a very rich botanical wealth and a large number of diverse types of plants grow in different parts of the country. This review examine about wound healing prospective of plants, its family, part used, extract used, model used and references which are supportive for researchers for expansion of novel wound healing formulation.

Keywords: Wound; Types of wounds; Healing; Phyto-medicine; Herbal plants.

INTRODUCTION

Since time immemorial man has used various parts of plants in the treatment and prevention of many ailments. Historically all medicinal preparations were derived from plants, whether in the simple form of plant parts or in the more complex form of crude extracts, mixtures, etc.1 Plant based drugs were commonly used in India and China.2 A wound may be defined as a break in the epithelial integrity of the skin or may also be defined as a loss or breaking of cellular and anatomic or functional continuity of living tissue.3 According to the Wound Healing Society, wounds are physical injuries that result in an opening or break of the skin that cause disturbance in the normal skin anatomy and function.4 When skin is torn, cut, or punctured it is termed as an open wound and when force trauma causes a contusion, it is called closed wound, whereas the burn wounds are caused by fire, heat, radiation, chemicals, electricity, or sunlight.5

"Best practice requires the assessment of the whole patient, not just the hole in the patient. All possible contributing factors must be explored." The therapeutic efficacies of many indigenous plants for various diseases have been described by traditional herbal medicine practitioners.6

TYPES OF WOUND

Wounds are classified as open and closed wound on the underlying cause of wound creation and acute and chronic wounds on the basis of physiology of wound healing.

1. Open wounds

2. Closed wounds

3. Acute wounds

4. Chronic wounds

Open wounds

In this case blood escapes the body and bleeding is clearly visible. It is further classified as: Incised wound, laceration or tear wound, Abrasions or superficial wounds, Puncture wounds, Penetration wounds and gunshot wounds.7

Closed wounds

In closed wounds blood escapes the circulatory system but remains in the body. It includes Contusion or bruises, heamatomas or blood tumor, Crush injury etc.

Acute wounds

Acute wound is a tissue injury that normally precedes through an orderly and timely reparative process that result in sustained restoration of anatomic and functional integrity. Acute wounds are usually caused by cuts or surgical incisions and complete the wound healing process within the expected time frame.8

Chronic wounds

Chronic wounds are wounds that have failed to progress through the normal stages of healing and therefore enter a state of pathologic inflammation chronic wounds either require a prolonged time to heal or recur frequently. Local infection, hypoxia, trauma, foreign bodies and systemic problems such as diabetes mellitus, malnutrition, immunodeficiency or medications are the most frequent causes of chronic wounds.9

WOUND HEALING MECHANISM

Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing.10

DESCRIPTION OF FEW PLANTS

Asparagus racemosus12

The wound healing profile of Asparagus racemosus on incision and excision wound models in rats. The aqueous extract of the roots of Asparagus racemosus is made use of to study the effect on wound healing in albino rats using incision and excision wound models in 200mg/kg and 400mg/kg orally for 10 to 22 days. The skin breaking strength, epithelialisation period, wound contraction rate were estimated. The extract showed significant improvement in the epithelialisation period, remarkable enhancement of wound contraction rate, increased skin breaking strength in the test groups.

Aspila africana14

The methanol leaf extract of Aspila africana formulated as gels was studied for its potency on experimentally-induced wound in rats. The extract was formulated as hydrogel and xerogel. The wound healing effects of the formulations were compared to that of a standard antibiotic, Cicatrin® together with the gel bases. A 100% wound closure was observed by the 17th day post wound day in both gel formulations of the extract and the standard. It was concluded that the extract formulated in gel forms were effective in healing wounds.

Allium cepa L.15

The wound healing activity of different extracts of Allium cepa L. in excision, incision and dead space wound models in albino rats. Alcoholic extract of Tubers of Allium cepa has shown better wound healing activity in excision, incision and dead space wound models as compared to chloroform and chloroform water extracts. From the results obtained it can be concluded that alcoholic extract of tubers of Allium cepa has significant wound healing activity.

Barleria montana16

Ethanolic extract of Barleria montana leaves were used to evaluate its wound healing activity in rats. Rate of wound contraction were taken as parameters. The wound healing activity of topically applied extract of leaf of Barleria montana was evaluated in albino rat by excision wound model for a period of 16 days. Extract of Barleria montana showed marked reduction in wound area in comparison to control group from 4th day onwards.

Carica papaya19

The wound healing potential of aqueous extract of roots of Carica papaya was examined for wound healing activity at doses 200 mg/kg which was evaluated for its wound healing activity in albino rats using excision and incision wound models. Latex treated animals exhibit 89.40 % reduction in wound area when compared to controls which was 80.38 %. The extract treated wounds are found to epithelise faster as compared to controls.

Calotropis gigantean22

The Latex of Calotropis gigantean (200 mg/kg/day) was evaluated for its wound healing activity in albino rats using excision and incision wound models. Latex treated animals exhibit 83.42 % reduction in wound area when compared to controls which was 76.22 %. The extract treated wounds are found to epithelize faster as compared to controls.

Ficus racemosa Linn25

The wound healing activity of topically applied extract of fruit of Ficus racemosa Linn was evaluated in albino rat by excision wound model for a period of 16 days. Extract of Ficus racemosa Linn showed marked reduction in wound area in comparison to control group from 4th day onwards. The result obtained indicates that aqueous extract of Ficus racemosa Linn accelerates the wound healing process by decreasing the surface area of the wound.

Gossypium herbaceum26

The effect of Gossypium herbaceum on experimentally induced wounds in rats and compare the effects observed with an antiseptic agent, povidine iodine ointment. The models selected were excision wound, incision wound and dead space wound. In incision and excision models, a significant decrease in period of epithelization and wound contraction was observed in all the treatment groups when compared to control. In the incision wound model, a significant increase in the breaking strength was observed. Granulation tissue formation significantly increased in all treated animals compare to control. It was concluded that extract administered orally (200mg/kg) possesses wound healing activity.

Momordica balsamina Linn35

Hexane and methanolic extract of fruit pulp of M. balsamina on wound healing activity through oral and topical routes on excision wound model. The activity was compared with standard drug Ciprofloxacin (10 mg/kg) and Povidone iodine ointment (5% w/w] respectively. The hexane extract was found to have better wound healing effect than methanolic extract on both route of administration and the oral route of administration shows faster rate of healing when compared with topical application.

Urena lobata L.48

The methanolic extract of Urena lobata L.(MEUL) in excision, incision, burn wound and dead space on albino rats. Two doses (200mg/kg, 400mg/kg] were selected based on the acute toxicity studies; there was no mortality up to 4000mg/kg. The MEUL exhibited significant wound healing activity in excision, incision, burn, and dead space wound model, which is comparable to the marketed Povidone-Iodine formulation. A significant decrease in the period of epitheliazation and wound contraction as compared with control.

CONCLUSION

Wound-healing agents derived from plants need to be identified and formulated for treatment and management of wounds. Various herbal products have been used in management and treatment of wounds over the years. In this direction this review article has been written to enlist and abridge the herbal sources. This will help researchers in interest for developing new herbal wound healing medicinal formulations for human use so that many people get benefitted and overcome their long term disease in very short period.

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