Burn Wound Healing Effect of a Sterilized Traditional Formulation of Boswellia carteri vs. Silver Sulfadiazine Cream 1% in Patients Presenting Second-degree Burn Wounds: A Randomized, Double-blind Clinical Trial

Background

Burn wounds rank among the most serious healthcare issues. Many studies reported the effectiveness of natural products in the wound-healing process. The present study compared the effects of a standardized herbal formulation derived from Boswellia carteri (B. carteri) and silver sulfadiazine (SSD) cream 1% on the healing of burn wounds.

Methods

This randomized double-blind clinical trial was conducted at Shiraz Burn Hospital (Shiraz, Iran) between July 2012 to August 2013. A sterilized formulation comprising B. carteri 40% was prepared. 54 second-degree burn patients of both sexes with age ranges of 20 to 60 were invited to participate in this double-blind, randomized clinical trial. They were randomly divided into two groups and given either the Boswellia formulation or SSD cream. The healing index was determined based on the wound area assessment using the planimetry technique. The Kaplan-Meier survival analysis was used to assess the primary outcome, which was the amount of time until complete healing.

Results

The trial was completed by 17 patients from the SSD group and 15 patients from the Boswellia group. During the study period, both groups showed a progressive healing trend. The mean (95% CI) healing time in the SSD group was 10.94 (9.03-12.85) days and 10.73 (9.23-12.23) days in the Boswellia group (P=0.71), indicating no significant difference. On the 17^th day, the healing index of all patients in the Boswellia group reached 1.

Conclusion

Boswellia topical formulation had a burn wound healing effect comparable to that of the standard SSD 1% treatment. Based on the findings of this study, the likelihood of contact dermatitis with Boswellia should be taken into consideration.

An Investigation of Vascular Endothelial Growth Factor (VEGFR-1 and VEGFR-2) in Burn Wound Healing

Burn damage is a complicated trauma that causes local and general tissue edema as a result of cell breakage and capillary leak syndrome. Angiogenesis plays a key part in the mechanisms that are initiated by tissue damage (e.g., burns) since it works directly and precisely on endothelial cells. The primary mediators of angiogenesis are vascular endothelial growth factor (VEGF) and its receptors (VEGFR-1 and VEGFR-2). This study aimed to figure out what functions VEGF and its receptors play in wound healing after burn, and the systemic release of VEGF in people following severe burn damage. This study included 23 burnt adult serum and 20 healthy controls. The enzyme-linked immunosorbent test was used to assess circulating VEGF serum levels and its receptors (VEGFR-1 and VEGFR-2). VEGF serum levels were considerably higher in this study, compared to VEGF levels in healthy controls. The levels of VEGFR-1 and VEGFR-2 have significantly risen; moreover, VEGF and its receptors have a significant impact on edema-related problems in severely burned individuals. Burn is a frequent disease that damages the skin and induces the production of mediators that cause neovasculature in the majority of patients. VEGF, which causes vasculogenesis and angiogenesis, is one of the most important factors in the skin.