A critical overview of challenging roles of medicinal plants in improvement of wound healing technology

Abstract

Purpose: Chronic diseases often hinder the natural healing process, making wound infections a prevalent clinical concern. In severe cases, complications can arise, potentially leading to fatal outcomes. While allopathic treatments offer numerous options for wound repair and management, the enduring popularity of herbal medications may be attributed to their perceived minimal side effects. Hence, this review aims to investigate the potential of herbal remedies in efficiently treating wounds, presenting a promising alternative for consideration.

Methods: A literature search was done including research, reviews, systematic literature review, meta-analysis, and clinical trials considered. Search engines such as Pubmed, Google Scholar, and Scopus were used while retrieving data. Keywords like Wound healing 'Wound healing and herbal combinations', 'Herbal wound dressing', Nanotechnology and Wound dressing were used.

Result: This review provides valuable insights into the role of natural products and technology-based formulations in the treatment of wound infections. It evaluates the use of herbal remedies as an effective approach. Various active principles from herbs, categorized as flavonoids, glycosides, saponins, and phenolic compounds, have shown effectiveness in promoting wound closure. A multitude of herbal remedies have demonstrated significant efficacy in wound management, offering an additional avenue for care. The review encompasses a total of 72 studies, involving 127 distinct herbs (excluding any common herbs shared between studies), primarily belonging to the families Asteraceae, Fabaceae, and Apiaceae. In research, rat models were predominantly utilized to assess wound healing activities. Furthermore, advancements in herbal-based formulations using nanotechnology-based wound dressing materials, such as nanofibers, nanoemulsions, nanofiber mats, polymeric fibers, and hydrogel-based microneedles, are underway. These innovations aim to enhance targeted drug delivery and expedite recovery. Several clinical-based experimental studies have already been documented, evaluating the efficacy of various natural products for wound care and management. This signifies a promising direction in the field of wound treatment.

Conclusion: In recent years, scientists have increasingly utilized evidence-based medicine and advanced scientific techniques to validate the efficacy of herbal medicines and delve into the underlying mechanisms of their actions. However, there remains a critical need for further research to thoroughly understand how isolated chemicals extracted from herbs contribute to the healing process of intricate wounds, which may have life-threatening consequences. This ongoing research endeavor holds great promise in not only advancing our understanding but also in the development of innovative formulations that expedite the recovery process.

Keywords: Clinical trial; Herbs; Nanotechnology; Wound dressing; Wound healing.

Fig. 1

PRISMA flowchart of included article

Fig. 2

Wound healing process (A) Homeostasis: After injury, the body initiates homeostasis to stop bleeding and form a blood clot at the wound site. B Inflammation: The inflammatory phase involves the recruitment of immune cells to the wound to combat potential infections and clear debris. C Proliferation: During this stage, new tissue is generated to fill the wound gap. Cells such as fibroblasts produce collagen to build a new extracellular matrix, and new blood vessels form through angiogenesis. D Remodeling: In the final phase, the wound undergoes remodeling as the newly formed tissue matures and gains strength. Collagen fibers realign, and the wound’s overall tensile strength improves

Fig. 3

Diagnostic methods for identification of wound infections. Note: BPA: Bacterial protease activity; CRP: C-reactive protein; PCR: Polymerase chain reaction; PCT; Procalcitonin, CT: Computed tomography; MRI: Magnetic resonance imaging; PET: Positron emission tomography; SFDI: Spatial frequency domain imaging

Fig. 4

Nanotechnology used as drug delivery systems (Created by Biorender.com)

Fig. 5

%age of individual herbs from the same botanical family exhibit wound healing properties

Fig. 6

%age of herbs included in polyherbal formulations, which belong to the same botanical family, possess wound healing properties

Fig. 7

%age of herbs, found in both individual herb and polyherbal formulation studies, and belonging to the same botanical family, demonstrate wound healing properties across a total of 72 studies, which encompass 127 unique herbs (excluding duplicates)

Fig. 8

Herb-derived bioactive compounds for wound healing activity (from extraction to evaluation). The diagram illustrates the comprehensive process of harnessing bioactive compounds from selected herbs for wound healing. Primarily utilizing leaves, followed by roots, rhizomes, and flowers, the herbs undergo extraction with specific solvents. The extracted compounds are then utilized to prepare either individual herb formulations or polyherbal blends. These formulations are subsequently evaluated for wound healing efficacy through both in vivo and/or in vitro models, showcasing their diverse mechanisms in promoting wound recovery