A comparison of wound healing following treatment withLavandula xallardii honey or essential oil

Evidence for Natural Products as Alternative Wound-Healing Therapies

Chronic, non-healing wounds represent a significant area of unmet medical need and are a growing problem for healthcare systems around the world. They affect the quality of life for patients and are an economic burden, being difficult and time consuming to treat. They are an escalating problem across the developed world due to the increasing incidence of diabetes and the higher prevalence of ageing populations. Effective treatment options are currently lacking, and in some cases chronic wounds can persist for years. Some traditional medicines are believed to contain bioactive small molecules that induce the healing of chronic wounds by reducing excessive inflammation, thereby allowing re-epithelisation to occur. Furthermore, many small molecules found in plants are known to have antibacterial properties and, although they lack the therapeutic selectivity of antibiotics, they are certainly capable of acting as topical antiseptics when applied to infected wounds. As these molecules act through mechanisms of action distinct from those of clinically used antibiotics, they are often active against antibiotic resistant bacteria. Although there are numerous studies highlighting the effects of naturally occurring small molecules in wound-healing assays in vitro, only evidence from well conducted clinical trials can allow these molecules or the remedies that contain them to progress to the clinic. With this in mind, we review wound-healing natural remedies that have entered clinical trials over a twenty-year period to the present. We examine the bioactive small molecules likely to be in involved and, where possible, their mechanisms of action.

Bentonite Nanoparticles and Honey Co-Administration Effects on Skin Wound Healing: Experimental Study in the BALB/c MICE

In recent years, nanotechnology and the subsequent production of nanoparticles have developed excellent methods for medical applications, including wound healing. One of these nanoparticles is bentonite nanoparticles (BNPs) which show high ability in tissue engineering. But our knowledge of its effectiveness in wound healing is based on little data. Therefore, the main purpose of this study was to evaluate the wound healing ability of BNPs and in the next step the suitability of honey as a solvent for these nanoparticles. Methods: In this experimental study, an excisional wound injury model was developed in adult male BALB/c mice (n = 60) by creative two equal-sized wounds (5 mm) on either side of their back midline. The animals were allocated into five groups (n = 12 each) as untreated control (U), honey (H), polyethylene glycol (P), and (BNPs) dissolved in honey or polyethylene glycol (H + BNPs, P + BNPs). Animals have received their relative topical treatments twice per day for 14 consecutive days. Tissue sampling was carried out on days 4, 7, 10, and 14. The tissue sections were stained with hematoxylin and eosin and Trichrome-Masson staining methods. The histomorphological parameters including inflammatory cells infiltration, fibroblasts, re-epithelialization, granulation formation, and collagenases were evaluated in all tissue sections. Data were analyzed by SPSS 16 software. Comparison between the groups was performed by one-way analysis of variance following Tukey's post-hoc test. Compared to the control group, BNPs showed significant wound healing activities with lower inflammatory cells infiltration, higher fibroblastosis and new epithelium thickness, and greater granulation area and collagen fibers density in the ulcer bed. In addition, honey as a solvent synergistically increased the wound healing activity of the studied nanoparticle. These results for the first time are clearly showing that BNPs have a promising wound healing activity, especially when applied with honey concurrently.

Efficacy of Norway Spruce Ointments and Bacterial and Fungal Alterations in the Treatment of Castration Wounds in Piglets

This study aimed to evaluate the efficacy of Norway spruce ointments on wound healing of castration wounds in piglets. This study included 95 male pigs randomly divided into five treatment groups: Norway spruce balm (Vulpuran), Norway spruce resin (Abilar), pork lard (ointment base of Vulpuran), no treatment (negative control) and antibiotic blue spray (Cyclo spray, positive control). Wound healing parameters (such as healing time, wound size, reddening of wound edges and surrounding, swelling, secretion and wound contamination), microbiological status and the haptoglobin level as an inflammation parameter were investigated. In the Norway spruce groups, some positive effects on wound healing parameters were found. In the first 6 days of treatment, Abilar or Vulpuran showed the smallest means of wound areas, and at the end of the study (day 15 + 17), the highest rates of completely closed wounds compared to the other groups. Vulpuran treatment led to significantly lower wound secretion (p = 0.003) and wound contamination (p = 0.015) than the untreated control did. Furthermore, the microbiological status was determined using MALDI-TOF-MS and partial 16S rRNA gene sequencing at different days of treatment. A comparison of the five treatment groups on day 3 revealed that Norway spruce led to the lowest rate of wounds colonised with fungi, mainly classified into genus Candida, (Abilar 77%, Vulpuran 70%) in comparison with blue spray (89%), lard (100%) and untreated control (100%). Fungi could only be detected in one of the 13 samples treated with Vulpuran on day 8, which nearly reached significance (p = 0.055).

Herbal Oils for Treatment of Chronic and Diabetic Wounds: A Systematic Review

BACKGROUND

In the present scenario, diabetes is a growing health challenge, and its occurrence is growing across the globe. Diabetes, with its complications like diabetic wounds, vasculopathy, neuropathy, wound infections, and oxidative stress, is a serious cause of mortality worldwide.

INTRODUCTION

Among the various complications, treatment of diabetic foot and ulcers is one of the major concerns in patients who are suffering from diabetes. The causative factors for this condition include increased oxidative stress, high blood glucose levels, vascular insufficiency, and microbial infections, and many a time, if left untreated, it may even lead to amputations of the lower extremities. The present therapy for the treatment of diabetic wounds mainly involves the use of synthetic moieties and other biotechnology-derived biomolecules, including growth factors. Few plant products are also useful in the treatment of wounds.

METHODS

Essential oils derived from various herbs are reported to possess significant wound healing potential and promote blood clotting, help to fight infections, and accelerate the wound healing process. Hence, the present review is a systematic analysis of all the available data on the use of the natural oils with their biological source, active phytochemical constituents present, and the probable mechanism of action for the treatment of chronic and diabetic wounds in suitable animal models. A methodical collection of data was performed, and information was searched up to April 2020 in entirety. Key phrases used for the data search include the pathophysiology of wounds, diabetic foot wound and its complications, natural oils for chronic and diabetic wound treatment.

RESULTS

This review summarizes the natural oils which are reported in the literature to be beneficial in the treatment of chronic wounds, while some oils have been specifically also studied against wounds in diabetic rats. Essential oils are said to interact with the body pharmacologically, physiologically and psychologically and help in rapid wound healing. However, the majority of the literature studies have demonstrated wound healing activity only in animal models (preclinical data), and further clinical studies are necessary.

CONCLUSION

This review provides a platform for further studies on the effective utilization of natural oils in the treatment of chronic and diabetic wounds, especially if oils are to receive credibility in the management of chronic wounds.

Topical Emulsion Containing Lavandula stoechas Essential Oil as a Therapeutic Agent for Cutaneous Wound Healing

Background and objectives: The present research was designed to evaluate the chemical composition of Lavandula stoechas essential oil (EOLS) as well as the in vivo wound-healing property. The chemical composition of EOLS was identified by gas chromatography mass spectrometry. Nineteen compounds of EOLS were reported. Linalool was identified as the major chemical compound (24.87%), followed by linalyl acetate (19.10%). EOLS showed a high content of oxygenated compounds (63.54%). In vivo wound healing activity of the topical cream prepared from EOLS (0.5% w/w) was assessed using a circular excision wound model. The wound area (mm2) in all animal groups was estimated and measured on day 0, 4, 8, 11, and 16. Results: The EOLS formulation cream (0.5% v/w) showed the highest effect on wound models when compared to reference Madecassol® (Asiaticoside). On days 4, 11, and 16, wound contractions were 26.4%, 78%, and 96.3% for the EOLS-treated group, and 8.5%, 64.1%, and 86.1% for the vehicle cream-treated group. Animals treated with EOLS cream showed a significant decrease in the epithelization period, wound area, and scar thickness, whereas the rate of wound contraction significantly increased. This is the first such report to be published. Histological analyses were also consistent with the results of the excision experimental method. Treatment with EOLS cream formulation resulted in decreased inflammation and an increased rate of tissue perfusion and proliferation as well as remodeling, along with re-epithelization. Conclusions: Our results support the use of EOLS in the development of pharmaceuticals for the management of wounds, and/or inflammatory-related diseases. Additional studies are needed to elucidate and explain the exact mechanism of its pharmacological activity.

In vitro and in vivo evaluation of a nanofiber wound dressing loaded with melatonin

Wound healing is a complicated process that takes a long time to complete. The three-layer nanofiber wound dressing containing melatonin is highly expected to show remarkable wound repair by reducing the wound healing time. In this study, chitosan (Cs)-polycaprolactone (PCL)/ polyvinylalcohol (PVA)-melatonin (MEL)/ chitosan-polycaprolactone three-layer nanofiber wound dressing was prepared by electrospinning for melatonin sustained release. The characteristics of the wound dressing were further evaluated. The wound dressing had a high water uptake after 24 h (401%), and the water contact angle results showed that it had hydrophilicity effect that supported the cell attachment. The wound healing effect of wound dressing was examined using a full-thickness excisional model of rat skin by the local administration of MEL. The gene expressions of transforming growth factor-beta (TGF-β1), alpha-smooth muscle actin (α-SMA), collagen type I (COL1A1), and collagen type III (COL3A1) were further studied. The histopathological evaluation showed the complete regeneration of the epithelial layer, remodeling of wounds, collagen synthesis, and reduction in inflammatory cells. The NF + 20% MEL significantly increased TGF-β1, COL1A1, COL3A1, and α-SMA mRNA expressions. This wound dressing may have a considerable potential as a wound dressing to accelerate the wound healing.

The Effects of Lavender Essential Oil on Wound Healing: A Review of the Current Evidence

Background: The commercialization of essential oils has expanded their presence in the United States, and emerging studies demonstrate that they may have a place in Western medicine. One oil with a significant body of evidence is lavender essential oil, which may have benefits in wound healing. Objectives: This review aims to present the scientific literature on therapeutic lavender essential oil with the goal of expanding the current repertoire of cost-effective wound healing options available to physicians and patients. Methods: A review was conducted according to PRISMA guidelines in PubMed, Cochrane Library, and Embase from June 2018 through March 2019 to identify articles related to lavender essential oil in the context of wound healing. Results: This search yielded 36 unique studies, 20 of which remained after screening. This review utilizes human clinical trials (n = 7), animal trials (n = 5), in vitro studies (n = 2), and previously conducted reviews (n = 6). Overall, these studies demonstrated a faster rate of wound healing, increased expression of collagen, and enhanced activity of proteins involved in the tissue remodeling process in wounds treated with lavender essential oil. Conclusions: The current body of literature suggests a potential therapeutic benefit of lavender essential oil in wound healing. However, standardization of the chemical composition and additional high-quality human clinical trials are needed to further evaluate the safety and efficacy of lavender essential oil in clinical practice.

Lavandula Essential Oils: A Current Review of Applications in Medicinal, Food, and Cosmetic Industries of Lavender

The global essential oil market has been steadily increasing in size over the past few years, and is estimated to reach ca. $7.5 billion USD per annum by 2018. Lavenders ( Lavandula; Lamiaceae) contribute significantly to this market, yielding ca. 1500 tons of essential oils which are primarily used in cosmetics, personal care products, and medicines. Recent literature indicates that these oils may also have applications in food preservation and pest control, among others. The medicinal and pharmaceutical properties of lavenders are chiefly due their essential oils, in particular the major essential oil constituents linalool and linalyl acetate, although certain activities have been attributed to the phenolic compounds. In addition, there is evidence that the major and minor essential oil constituents act synergistically to provide various biological effects. A substantial amount of current research focuses on evaluating the biological activities of lavender essential oils for potential use in traditional and complementary medicine, food systems, cosmetic and fragrance formulations, and insect control products. This review examines recent progress in these areas, and highlights the current and future implications for these economically and medicinally valuable plants.

Therapeutic Effects of Medicinal Plants on Cutaneous Wound Healing in Humans: A Systematic Review

The pharmaceutical industry has made great strides in providing drugs that are able to stimulate the healing process, but only 1-3% of all drugs that are listed in Western pharmacopoeias are intended for use on the skin or cutaneous wounds. Of these, at least one-third are obtained from plants. We sought to review the therapeutic effects of medicinal plants on human skin lesions. For this systematic review, we searched the PubMed, Scopus, and Web of Science databases to identify clinical trials that were published from 1997 to 2017. We reviewed studies that described the use of medicinal plants for the treatment of skin lesions in humans. Ten studies were selected, eight of which were published from 2007 to 2016, with a total of 503 patients. Among the plant species that were used for the treatment of human skin lesions, 12 belonged to 11 families and were included in the analysis. All of the plant species that were studied presented high therapeutic potential for the treatment of cutaneous lesions.

Antibacterial activity and chemical characteristics of several Western Australian honeys compared to manuka honey and pasture honey

The physicochemical parameters and antibacterial activity of 10 Western Australian (WA) and two comparator honeys were determined. Honeys showed a pH range of 4.0-4.7, colour range of 41.3-470.7 mAU, methylglyoxal levels ranging from 82.2 to 325.9 mg kg^-1 and hydrogen peroxide levels after 2 h of 22.7-295.5 µM. Antibacterial activity was assessed by the disc diffusion assay, phenol equivalence assay, determination of minimum inhibitory and bactericidal concentrations and a time-kill assay. Activity was shown for all honeys by one or more method, however, activity varied according to which assay was used. Minimum inhibitory concentrations for WA honeys against 10 organisms ranged from 4.0 to >32.0% (w/v). Removal of hydrogen peroxide activity by catalase resulted in decreased activity for several honeys. Overall, the data showed that honeys in addition to those derived from Leptospermum spp. have antimicrobial activity and should not be overlooked as potential sources of clinically useful honey.

Lavandula angustifolia Extract Improves the Result of Human Umbilical Mesenchymal Wharton's Jelly Stem Cell Transplantation after Contusive Spinal Cord Injury in Wistar Rats

Introduction. The primary trauma of spinal cord injury (SCI) results in severe damage to nervous functions. At the cellular level, SCI causes astrogliosis. Human umbilical mesenchymal stem cells (HUMSCs), isolated from Wharton's jelly of the umbilical cord, can be easily obtained. Previously, we showed that the neuroprotective effects of Lavandula angustifolia can lead to improvement in a contusive SCI model in rats. Objective. The aim of this study was to investigate the effect of L. angustifolia (Lav) on HUMSC transplantation after acute SCI. Materials and Methods. Sixty adult female rats were randomly divided into eight groups. Every week after SCI onset, all animals were evaluated for behavior outcomes. H&E staining was performed to examine the lesions after injury. GFAP expression was assessed for astrogliosis. Somatosensory evoked potential (SEP) testing was performed to detect the recovery of neural conduction. Results. Behavioral tests showed that the HUMSC group improved in comparison with the SCI group, but HUMSC + Lav 400 was very effective, resulting in a significant increase in locomotion activity. Sensory tests and histomorphological and immunohistochemistry analyses verified the potentiation effects of Lav extract on HUMSC treatment. Conclusion. Transplantation of HUMSCs is beneficial for SCI in rats, and Lav extract can potentiate the functional and cellular recovery with HUMSC treatment in rats after SCI.

A Comparison Study of Growth Factor Expression following Treatment with Transcutaneous Electrical Nerve Stimulation, Saline Solution, Povidone-Iodine, and Lavender Oil in Wounds Healing

This study compared the effects of transcutaneous electrical nerve stimulation (TENS), saline solution (SS), povidone-iodine (PI), and lavender oil (Lavandula angustifolia) through expression of growth factors in a rat model of wound healing. Six experimental groups were established, each containing 8 rats: a healthy group with no incision wounds, an incision-control group, an incision and TENS group, an incision and SS group, an incision and PI group, and an incision and lavender oil group. Experiments continued for 5 days, after which the skin in the excision area was removed. Tissue concentrations of epidermal growth factor (EGF) and platelet-derived growth factor (PDGF)-A were measured using enzyme-linked immunosorbent assay (ELISA). Tissue expressions of EGF, PDGF-A, and fibroblast growth factor (FGF)-2 were determined using immunohistochemistry. Wound closure progressed more rapidly in the TENS and lavender oil groups than in the control and other study groups. In particular, PDGF-A expressions in the dermis and EGF expression in the epidermis were significantly intense in the TENS group (P < 0.05). In addition, ELISA levels of growth factors such as PDGF-A and EGF were significantly higher in TENS group compared to the control group (P < 0.05). These immunohistochemical and ELISA results suggest that TENS may improve wound healing through increasing growth factors in the dermis and epidermis more than other topical applications.

Common complementary and alternative therapies with potential use in dermatologic surgery: risks and benefits

BACKGROUND

Ambulatory surgery patients often use complementary and alternative medicine (CAM) therapies. CAM therapies may create beneficial and detrimental perioperative conditions.

OBJECTIVE

We sought to improve knowledge of CAM effects in dermatologic surgery, allowing dermatologists to potentially capitalize on therapeutic actions and to mitigate complications.

METHODS

PubMed literature search of CAM therapies in dermatologic and surgical settings was performed. Common CAM therapies with possible effects on dermatologic surgery were selected. Beneficial and detri-mental effects were reviewed.

RESULTS

A myriad of products may be used perioperatively by the patient. Therapies appearing to have some evidence for potential benefit include bromelain, honey, propolis, arnica, vitamin C and bioflavonoids, chamomile, aloe vera gel, grape seed extract, zinc, turmeric, calendula, chlorella, lavender oil, and gotu kola. Potential complications vary according to product and include platelet inhibition, contact dermatitis and, in rare cases, systemic toxicity.

LIMITATIONS

This review focuses on CAM having significant published studies evaluating efficacy for wound healing, anti-inflammatory, antipurpuric, or perioperative-related use. Most published studies have been small and often have design flaws. The scope of CAM is large and not all therapies are discussed.

CONCLUSION

Selected CAM therapies have been reported to promote wound healing, reduce edema or purpura, and provide anti-inflammatory effects. Because of high rates of CAM use, surgeons should familiarize themselves with common uses, potential benefits, and complications. Further study of effects in the dermatologic surgery setting may improve the patient-doctor relationship and enhance outcomes.