Assessment of Wound Healing Activity of the Aqueous Extracts of Colutea cilicica Boiss. & Bal. Fruits and Leaves

Sinapic acid-loaded gel accelerates diabetic wound healing process by promoting re-epithelialization and attenuating oxidative stress in rats

Impaired wound healing is a critical health concern for individuals with diabetes. Sinapic acid, a phyto-compound, has wound-healing potential owing to its various bioactivities. In this study, we explored the wound-healing ability of sinapic acid in diabetes. Full-thickness excisional wounds were created in streptozotocin-induced diabetic rats. Sinapic acid-loaded gels (1%, 2%, and 3%) were prepared and applied topically to diabetic skin wounds. On day 7 post-wounding, rats were sacrificed, and macroscopic, histopathological, and oxidative markers of wound healing activity were evaluated in the collected wound tissues. Sinapic acid-loaded gels showed better recovery in re-epithelialization (p < 0.05) and angiogenesis (p < 0.05) compared to the negative control group. Sinapic acid-loaded gels (1%, 2%, and 3%) showed 87.46%, 79.53%, and 68.78% wound contraction, respectively. They increased collagen content (28.05 ± 1.66, 17.30 ± 2.19, and 11.64 ± 1.25, respectively) and decreased malondialdehyde (MDA) levels (17.49 ± 1.61, 18.44 ± 1.24, and 19.16 ± 1.77, respectively) compared to the negative control group (6.76 ± 0.89, and 43.58 ± 3.70, respectively) (p < 0.05). Moreover, sinapic acid-loaded gel groups demonstrated enhanced antioxidant capacity (approximately 2-2.5-fold) compared to the negative control group (p < 0.05). Sinapic acid 1% loaded gel showed the best effect on the diabetic healing process, whereas sinapic acid 2% loaded gel and reference drug showed similar effects. The results of this study, for the first time, suggest that the topical application of sinapic acid can promote diabetic wound healing, especially at low doses.

Plant Leaves Extract Irrigation on Wound Healing in Diabetic Foot Ulcers

Purpose

We aimed to evaluate and compare the efficacy of neem leaves extract with normal saline irrigation practice in wound dressing on healing outcome and clinic-physiological parameters among individuals with diabetic foot ulcer (DFU).

Methods

A quasiexperimental with repeated measures design was used on two study groups. One group received neem leaf extract wound irrigation and another group received normal saline wound irrigation. Study participants were randomly assigned to each group from 100 DFU individuals. Demographic and clinical data sheets were used to collect baseline information. Random blood sugar and HbA1C measurement was performed on the initial day of visit for all participants. We used the PUSH tool for wound assessment (wound surface area, exudate amount, and tissue type), and clinic physiological parameters (temperature, pulse rate, respiration, blood pressure, wound pain, wound infection, and local warmth) assessment was performed at baseline and then at the end of each week till four weeks were completed. Participants attended a foot clinic every 3rd or 4th day for wound care.

Results

Reduction of wound healing score (PUSH score) and other wound variables improved significantly in the neem leaves extract group (p < 0.001). There were no significant changes in the clinic-physiological parameters.

Conclusion

Neem leaves extract irrigation for foot ulcers is considered to be very safe as it did not cause any complication systematically during the study. Neem leaf extract solution can be used as an alternative solution for normal saline. Managing DFU requires continuous foot care and early risk identification of ulcer.

Medicinal plants and their effects on diabetic wound healing

Wounds have a serious negative impact on the health-care economy of a country, especially on the economy of developing countries where resources are poor and funding is very limited. It is presumed that about 80% of people living in developing countries use traditional medicines which are majorly prepared from medicinal plants to meet their primary health-care needs. Due to the large reservoir of medicinal plants and adequate traditional knowledge on wound healing, many people in Africa and other developing countries use medicinal plants in the treatment of diabetic wounds and related complications. Wound healing in the external and internal biological organs involves a series of complex overlapping processes which demand excellent communication between cells. It is an orderly and highly controlled process characterized by hemostasis, inflammation, proliferation, and remodeling. Diabetes is a global health problem predicted to rise to over 642 million by 2040. The propelling factor responsible for the increase in morbidity and mortality of diabetes is linked to vascular complications as well as the failure of the wound healing processes in diabetic state. Different approaches have been adopted in the treatment of diabetic wounds, and medicinal plants are certainly one of those approaches that have drawn global attention. In this review paper, the effects of medical plants on wound healing in diabetic state as well as factors affecting wound healing and the mechanism of action of medicinal plants are examined.

Wound healing and antibacterial properties of methanolic extract of Pupalia lappacea Juss in rats

BACKGROUND

Wound healing is a natural process that enables tissue repair after an injury. To shorten its duration and minimize associated complications, wounds are treated with medications. Currently there is a growing interest in the use of alternative wound dressing agents such as plant extracts. One plant used traditionally in wound treatment is Pupalia lappacea. In view of its use in wound care, we investigated the wound healing activities of 80% methanolic leave extract of Pupalia lappacea using excision, incision and dead space wound models. Also its effects on three common wound contaminants were investigated.

METHODS

Excision wounds were created, contaminated with microbes and treated with ointments (10% and 20% w/w) prepared from Pupalia lappacea. Incision and dead space wounds were also created in rats which were subsequently dosed orally with the extract. The wound healing activities of Pupalia lappacea ointment on excision wound was assessed by rates of wound contraction and epithelialization as well as its antibacterial effects. The effects of Pupalia lappacea on incision and dead-space wounds were determined by the wound breaking strengths and weights of the granuloma tissues formed, respectively.

RESULTS

Pupalia. lappacea ointments significantly (p<0.05) accelerated wound healing with 20% ointment having the highest percentage wound contraction and rate of epithelialization. At 4, 7 and 14 days post treatment, mean total viable bacterial count of excision wounds of the extract treated groups were significantly (p<0.05) lower compared against the control. Wound breaking strengths and weights of granuloma tissues formed in the extract treated groups were significantly (p<0.05) higher than those of the control group. The minimum inhibitory concentration values obtained for the Pupalia lappacea extract against Pseudomonas aeruginosa, Staphylococcus aureus and Bacillus subtilis were 9 mg/ml, 4 mg/ml and 3 mg/ml, respectively, while the corresponding minimum bactericidal concentrations were 10 mg/ml, 8 mg/ml and 7 mg/ml.

CONCLUSION

The results obtained showed that Pupalia. lappacea has good wound healing and antibacterial activities. These findings validate the use of this plant in traditional medicine for treatment of wounds.

Effects of the Topical Application of Hydroalcoholic Leaf Extract of Oncidium flexuosum Sims. (Orchidaceae) and Microcurrent on the Healing of Wounds Surgically Induced in Wistar Rats

This study evaluated the wound healing activity of hydroalcoholic leaf extract of Oncidium flexuosum Sims. (Orchidaceae), an important native plant of Brazil, combined or not with microcurrent stimulation. Wistar rats were randomly divided into four groups of nine animals: control (C), topical application of the extract (OF), treated with a microcurrent (10 μA/2 min) (MC), and topical application of the extract plus microcurrent (OF + MC). Tissue samples were obtained 2, 6, and 10 days after injury and submitted to structural and morphometric analysis. The simultaneous application of OF + MC was found to be highly effective in terms of the parameters analyzed (P < .05), with positive effects on the area of newly formed tissue, number of fibroblasts, number of newly formed blood vessels, and epithelial thickness. Morphometric data confirmed the structural findings. The O. flexuosum leaf extract contains active compounds that speed the healing process, especially when applied simultaneously with microcurrent stimulation.

Practices in wound healing studies of plants

Wounds are the result of injuries to the skin that disrupt the other soft tissue. Healing of a wound is a complex and protracted process of tissue repair and remodeling in response to injury. Various plant products have been used in treatment of wounds over the years. Wound healing herbal extracts promote blood clotting, fight infection, and accelerate the healing of wounds. Phytoconstituents derived from plants need to be identified and screened for antimicrobial activity for management of wounds. The in vitro assays are useful, quick, and relatively inexpensive. Small animals provide a multitude of model choices for various human wound conditions. The study must be conducted after obtaining approval of the Ethics Committee and according to the guidelines for care and use of animals. The prepared formulations of herbal extract can be evaluated by various physicopharmaceutical parameters. The wound healing efficacies of various herbal extracts have been evaluated in excision, incision, dead space, and burn wound models. In vitro and in vivo assays are stepping stones to well-controlled clinical trials of herbal extracts.