Advertisement

Current Dermatology Reports

, Volume 7, Issue 4, pp 287–295 | Cite as

Wound Healing with Botanicals: a Review and Future Perspectives

  • Cassandra L. Quave
Wound Care and Healing (H Lev-Tov, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Wound Care and Healing

Abstract

Purpose of Review

Botanicals have long played a crucial role in the management of chronic and infected wounds, yet the mechanistic basis of these therapies remains largely poorly understood by modern science.

Recent Findings

Studies have begun to unveil the mechanistic bases of botanical therapies for wound healing, but more work is necessary. Most notably, investigation into the growing conditions, post-harvest treatment, and pharmacological preparation of these botanicals has demonstrated their importance in terms of the chemical makeup and pharmacological activity of the final product used in pre-clinical and clinical studies.

Summary

This work evaluates the potential safety, efficacy, and mechanistic basis of some key botanical ingredients used in traditional medicine for wound care: aloe, marigold, and St. John’s Wort. Furthermore, perspectives on the future role that botanical natural products may play in anti-infective and wound care, innovations are explored.

Keywords

Wounds Botanicals Wound healing Medicinal plants Complementary medicine Infection 

Notes

Funding information

Work in the Quave Research Group is funded by the National Institutes of Health, National Institute of Allergy and Infectious Disease (R21 AI136563, PI: CLQ). The funding agency had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with Ethical Standards

Conflict of Interest

The author is an inventor on patents concerning botanical inhibitors of microbial biofilm formation and quorum sensing; the author confirms that any competing interests do not alter her adherence to journal policies on ethics and sharing data or materials. The author provided consulting services to Medline during the period of writing this study. The author declares that provision of these services did not have any impact on the present study.

Dr. Quave reports grants from National Institutes of Health, National Institute of Allergy and Infectious Disease, from null, during the conduct of the study; personal fees from Medline, from null, outside the submitted work. In addition, Dr. Quave has a patent Quave, C.L., M.S. Smeltzer, C.M. Compadre, H. Hendrickson. Anti-biofilm compositions and methods for using Patent Numbers: WO2012048119-A2; US2012088671-A1; WO2012048119-A3. Derwent Primary Accession No.: 2012-E22562; Issued June 3, 2014; US 9,351,492 B2 Issued May 31, 2016 issued, a patent Quave, C.L., A.R. Horswill, J.T. Lyles. Botanical extracts and compounds from Castanea plants and methods of use. Provisional Filed June 26, 2015. Serial No. 62/185,146. Non-Provisional Filed June 24, 2016 Serial No. 15/195,514 pending, and a patent Quave, C.L. and J.T. Lyles. Botanical extracts and compounds from Schinus plants and methods of use. Provisional filed July 10, 2015; serial no. 62/190,802; non-provisional filed July 8, 2016; serial no. 15/205,493, pending.

Ethics Statement

All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki Declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily reflect the official views of the NIH or NIAID.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Pazyar N, Yaghoobi R, Rafiee E, Mehrabian A, Feily A. Skin wound healing and phytomedicine: a review. Skin Pharmacol Physiol. 2014;27(6):303–10.CrossRefGoogle Scholar
  2. 2.
    Willis KJ. State of the World’s plants report. London, England: Royal Botanic Gardens, Kew; 2017.Google Scholar
  3. 3.
    The Plant List Version 1.1. Published on the Internet. 2013. http://www.theplantlist.org/. Accessed September 9 2018.
  4. 4.
    Stevens PF. Angiosperm Phylogeny Website, version 14. 2001 Onwards. http://www.mobot.org/MOBOT/research/APweb/. Accessed September 10 2018.
  5. 5.
    Carter S, Newton LE, Lavranos JJ, Walker CC. Aloes: the definitive guide. London: Royal Botanic Gardens, Kew; 2011.Google Scholar
  6. 6.
    Ross IA. Medicinal plants of the world: chemical constituents, traditional, and modern medicinal uses. Humana Press; 1999.Google Scholar
  7. 7.
    Femenia A, Sánchez ES, Simal S, Rosselló C. Compositional features of polysaccharides from Aloe vera (Aloe barbadensis Miller) plant tissues. Carbohydr Polym. 1999;39(2):109–17.  https://doi.org/10.1016/S0144-8617(98)00163-5.CrossRefGoogle Scholar
  8. 8.
    Tizard IR, Ni Y. Carbohydrates, immune stimulating. In: Delves PJ, editor. Encyclopedia of immunology. Second ed. Oxford: Elsevier; 1998. p. 427–31.CrossRefGoogle Scholar
  9. 9.
    Wamer WG, Vath P, Falvey DE. In vitro studies on the photobiological properties of aloe emodin and aloin a. Free Radic Biol Med. 2003;34(2):233–42.CrossRefGoogle Scholar
  10. 10.
    •• Minjares-Fuentes R, Femenia A, Comas-Serra F, Rodríguez-González VM. Compositional and structural features of the main bioactive polysaccharides present in the Aloe vera plant. J AOAC Int. 2018;101. Doi: https://doi.org/10.5740/jaoacint.18-0119. This study examines the variability in compositional features of Aloe vera gel and provides a chemical explanation for differences in the pharmacology of aloe shown in the literature. CrossRefGoogle Scholar
  11. 11.
    Teplicki E, Ma Q, Castillo DE, Zarei M, Hustad AP, Chen J, et al. The effects of Aloe vera on wound healing in cell proliferation, migration, and viability. Wounds. 2018;30(9):263–8.Google Scholar
  12. 12.
    Maenthaisong R, Chaiyakunapruk N, Niruntraporn S, Kongkaew C. The efficacy of aloe vera used for burn wound healing: a systematic review. Burns: J Int Soc Burn Injuries. 2007;33(6):713–8.  https://doi.org/10.1016/j.burns.2006.10.384.CrossRefGoogle Scholar
  13. 13.
    Cuttle L, Kempf M, Kravchuk O, George N, Liu PY, Chang HE, et al. The efficacy of Aloe vera, tea tree oil and saliva as first aid treatment for partial thickness burn injuries. Burns: J Int Soc Burn Injuries. 2008;34(8):1176–82.  https://doi.org/10.1016/j.burns.2008.03.012.CrossRefGoogle Scholar
  14. 14.
    • Sari Y, Purnawan I, Kurniawan DW, Sutrisna E. A comparative study of the effects of Nigella sativa oil gel and Aloe vera gel on wound healing in diabetic rRats. J Evidence-based Integr Med. 2018;23:2515690X18772804.  https://doi.org/10.1177/2515690X18772804 This study examines two popular traditional medicines for wound care and offers comparative insight into the efficacy of Aloe vera over that of another botanical. CrossRefGoogle Scholar
  15. 15.
    Rodrigues LO, de Oliveira ACL, Tabrez S, Shakil S, Khan MI, Asghar MN, et al. Mutagenic, antioxidant and wound healing properties of Aloe vera. J Ethnopharmacol. 2018;227:191–7.  https://doi.org/10.1016/j.jep.2018.08.034.CrossRefPubMedGoogle Scholar
  16. 16.
    • Woeller Collynn F, Woodroof A, Cottler Patrick S, Pollock Stephen J, Haidaris Constantine G, Phipps RP. In vitro characterization of variable porosity wound dressing with anti-scar properties. Eplasty. 2018;18:e21 This study offers an interesting perspective on the incorporation of botanicals into medical devices for the promotion of wound healing. PubMedPubMedCentralGoogle Scholar
  17. 17.
    Coelho FH, Salvadori G, Rados PV, Magnusson A, Danilevicz CK, Meurer L, et al. Topical Aloe vera (Aloe barbadensis Miller) extract does not accelerate the oral wound healing in rats. Phytother Res. 2015;29(7):1102–5.  https://doi.org/10.1002/ptr.5352.CrossRefPubMedGoogle Scholar
  18. 18.
    Dat AD, Poon F, Pham KBT, Doust J. Aloe vera for treating acute and chronic wounds. Cochrane Database Syst Rev 2012(2). doi: https://doi.org/10.1002/14651858.CD008762.pub2.
  19. 19.
    Korac RR, Khambholja KM. Potential of herbs in skin protection from ultraviolet radiation. Pharm Rev. 2011;5(10):164–73.  https://doi.org/10.4103/0973-7847.91114.CrossRefGoogle Scholar
  20. 20.
    Lloyd EC, Rodgers BC, Michener M, Williams MS. Outpatient burns: prevention and care. Am Fam Physician. 2012;85(1):25–32.PubMedGoogle Scholar
  21. 21.
    Burusapat C, Supawan M, Pruksapong C, Pitiseree A, Suwantemee C. Topical Aloe vera gel for accelerated wound healing of split-thickness skin graft donor sites: a double-blind, randomized, controlled trial and systematic review. Plast Reconstr Surg. 2018;142(1):217–26.CrossRefGoogle Scholar
  22. 22.
    Basch E, Bent S, Foppa I, Haskmi S, Kroll D, Mele M, et al. Marigold (Calendula officinalis L.): an evidence-based systematic review by the natural standard research collaboration. J Herb Pharmacother. 2006;6(3/4):135–59.  https://doi.org/10.1300/J157v06n03-08.
  23. 23.
    Khalid KA, da Silva JAT. Biology of Calendula officinalis Linn.: focus on pharmacology, biological activities and agronomic practices. Medicinal and Aromatic Plant Sci Biotechnol. 2012;6(1):12–27.Google Scholar
  24. 24.
    De Feo V, Aquino R, Menghini A, Ramundo E, Senatore F. Traditional phytotherapy in the Peninsula Sorrentina, Campania, southern Italy. J Ethnopharmacol. 1992;36(2):113–25.  https://doi.org/10.1016/0378-8741(92)90010-O.CrossRefPubMedGoogle Scholar
  25. 25.
    Neves JM, Matos C, Moutinho C, Queiroz G, Gomes LR. Ethnopharmacological notes about ancient uses of medicinal plants in Trás-os-Montes (northern of Portugal). J Ethnopharmacol. 2009;124(2):270–83.  https://doi.org/10.1016/j.jep.2009.04.041.CrossRefPubMedGoogle Scholar
  26. 26.
    • Jarić S, Kostić O, Mataruga Z, Pavlović D, Pavlović M, Mitrović M, et al. Traditional wound-healing plants used in the Balkan region (Southeast Europe). J Ethnopharmacol. 2018;211:311–28.  https://doi.org/10.1016/j.jep.2017.09.018 This is a literature review of 128 plant species used in traditional remedies for wound healing in the Balkans. It highlights the medicinal applications of Calendula officinalis and Hypericum perforatum for these purposes. CrossRefPubMedGoogle Scholar
  27. 27.
    Mustafa B, Hajdari A, Krasniqi F, Hoxha E, Ademi H, Quave CL, et al. Medical ethnobotany of the Albanian Alps in Kosovo. J Ethnobiol Ethnomed. 2012;8:6.  https://doi.org/10.1186/1746-4269-8-6.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Mustafa B, Hajdari A, Pieroni A, Pulaj B, Koro X, Quave CL. A cross-cultural comparison of folk plant uses among Albanians, Bosniaks, Gorani and Turks living in south Kosovo. J Ethnobiol Ethnomed. 2015;11:39.  https://doi.org/10.1186/s13002-015-0023-5.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Jarić S, Popović Z, Mačukanović-Jocić M, Djurdjević L, Mijatović M, Karadžić B, et al. An ethnobotanical study on the usage of wild medicinal herbs from Kopaonik Mountain (Central Serbia). J Ethnopharmacol. 2007;111(1):160–75.  https://doi.org/10.1016/j.jep.2006.11.007.CrossRefPubMedGoogle Scholar
  30. 30.
    Lans C, Turner N, Khan T, Brauer G, Boepple W. Ethnoveterinary medicines used for ruminants in British Columbia. Can J Ethnobiol Ethnomed. 2007;3(1):11.CrossRefGoogle Scholar
  31. 31.
    Muley B, Khadabadi S, Banarase N. Phytochemical constituents and pharmacological activities of Calendula officinalis Linn (Asteraceae): a review. Tropical J Pharmaceutical Res. 2009;8(5).Google Scholar
  32. 32.
    Zitterl-Eglseer K, Sosa S, Jurenitsch J, Schubert-Zsilavecz M, Della Loggia R, Tubaro A, et al. Anti-oedematous activities of the main triterpendiol esters of marigold (Calendula officinalis L.). J Ethnopharmacol. 1997;57(2):139–44.  https://doi.org/10.1016/S0378-8741(97)00061-5.CrossRefPubMedGoogle Scholar
  33. 33.
    Preethi KC, Kuttan G, Kuttan R. Anti-inflammatory activity of flower extract of Calendula officinalis Linn. And its possible mechanism of action. Indian J Exp Biol. 2009;47(2):113–20.PubMedGoogle Scholar
  34. 34.
    Naeini A, Miri R, Shafiei N, Tabandeh M, Oryan A, Nazifi S. Effects of topical application of Calendula officinalis gel on collagen and hydroxyproline content of skin in rats. Comp Clin Pathol. 2012;21(3):253–7.  https://doi.org/10.1007/s00580-010-1087-1.CrossRefGoogle Scholar
  35. 35.
    Efstratiou E, Hussain AI, Nigam PS, Moore JE, Ayub MA, Rao JR. Antimicrobial activity of Calendula officinalis petal extracts against fungi, as well as Gram-negative and Gram-positive clinical pathogens. Complement Ther Clin Pract. 2012;18(3):173–6.  https://doi.org/10.1016/j.ctcp.2012.02.003.CrossRefPubMedGoogle Scholar
  36. 36.
    •• Nicolaus C, Junghanns S, Hartmann A, Murillo R, Ganzera M, Merfort I. In vitro studies to evaluate the wound healing properties of Calendula officinalis extracts. J Ethnopharmacol. 2017;196:94–103.  https://doi.org/10.1016/j.jep.2016.12.006 This study provides details on a useful model for in vitro evaluation of botanical extracts for potential mechanisms of wound healing. CrossRefPubMedGoogle Scholar
  37. 37.
    •• Buzzi M, de Freitas F, Winter M. A prospective, descriptive study to assess the clinical benefits of using Calendula officinalis hydroglycolic extract for the topical treatment of diabetic foot ulcers. Ostomy Wound Manage. 2016;62(3):8–24 This study demonstrates promising data on the topical spray application of C. officinalis extracts in diabetic foot ulcers. In addition to observations of wound closure in many patients, there was also a reduction in odorous wounds. PubMedGoogle Scholar
  38. 38.
    Panahi Y, Sharif MR, Sharif A, Beiraghdar F, Zahiri Z, Amirchoopani G, et al. A randomized comparative trial on the therapeutic efficacy of topical Aloe vera and Calendula officinalis on diaper dermatitis in children. Sci World J. 2012;2012:810234–5.  https://doi.org/10.1100/2012/810234.Google Scholar
  39. 39.
    Bolderston A, Lloyd NS, Wong RKS, Holden L, Robb-Blenderman L. Supportive Care Guidelines Group of Cancer Care Ontario Program in Evidence-based Care. The prevention and management of acute skin reactions related to radiation therapy: a systematic review and practice guideline. Support Care Cancer. 2006;14(8):802.  https://doi.org/10.1007/s00520-006-0063-4.CrossRefPubMedGoogle Scholar
  40. 40.
    HMPC. Community Herbal Monograpg on Calendula officinalis L., flos. Committee on Herbal Medicinal Products (HMPC), European Medicines Agency. 2008.Google Scholar
  41. 41.
    Reider N, Komericki P, Hausen BM, Fritsch P, Aberer W. The seamy side of natural medicines: contact sensitization to arnica (Arnica montana L.) and marigold (Calendula officinalis L.). Contact Dermatitis. 2001;45(5):269–72.  https://doi.org/10.1034/j.1600-0536.2001.450503.x.CrossRefPubMedGoogle Scholar
  42. 42.
    Mattalia G, Quave CL, Pieroni A. Traditional uses of wild food and medicinal plants among Brigasc, Kyé, and Provençal communities on the Western Italian Alps. Genet Resour Crop Evol. 2013;60(2):587–603.  https://doi.org/10.1007/s10722-012-9859-x.CrossRefGoogle Scholar
  43. 43.
    Kültür S. Medicinal plants used in Kırklareli Province (Turkey). J Ethnopharmacol. 2007;111(2).CrossRefGoogle Scholar
  44. 44.
    Savikin K, Zdunic G, Menkovic N, Zivkovic J, Cujic N, Terescenko M, et al. Ethnobotanical study on traditional use of medicinal plants in South-Western Serbia. Zlatibor District J Ethnopharmacol. 2013;146(3):803–10.  https://doi.org/10.1016/j.jep.2013.02.006.CrossRefPubMedGoogle Scholar
  45. 45.
    Redžić SS. The ecological aspect of ethnobotany and ethnopharmacology of population in Bosnia and Herzegovina. Collegium Antropologicum. 2007;3:869–90.Google Scholar
  46. 46.
    Šarić-Kundalić B, Fritz E, Dobeš C, Saukel J. Traditional medicine in the pristine village of Prokoško Lake on Vranica Mountain, Bosnia and Herzegovina. Scientia Pharmaceutica. 2010;78(2):275–90.  https://doi.org/10.3797/scipharm.1003-06.CrossRefPubMedCentralGoogle Scholar
  47. 47.
    Mustafa B, Hajdari A, Pajazita Q, Syla B, Quave CL, Pieroni A. An ethnobotanical survey of the Gollak region. Kosovo Genet Resour Crop Evol. 2012;59(5):739–54.  https://doi.org/10.1007/s10722-011-9715-4.CrossRefGoogle Scholar
  48. 48.
    Yeşilada E, Honda G, Sezik E, Tabata M, Goto K, Ikeshiro Y. Traditional medicine in Turkey IV. Folk medicine in the Mediterranean subdivision. J Ethnopharmacol. 1993;39(1):31–8.  https://doi.org/10.1016/0378-8741(93)90048-A.CrossRefPubMedGoogle Scholar
  49. 49.
    Sezik E, Yeşilada E, Honda G, Takaishi Y, Takeda Y, Tanaka T. Traditional medicine in Turkey X. Folk medicine in Central Anatolia. J Ethnopharmacol. 2001;75(2):95–115.  https://doi.org/10.1016/S0378-8741(00)00399-8.CrossRefPubMedGoogle Scholar
  50. 50.
    Hölzl J, Petersen M. Chemical constituents of Hypericum species. In: Ernst E, editor. Hypericum: the genus Hypericum. New York: Taylor & Francis; 2003. p. 77–93.Google Scholar
  51. 51.
    Crockett SL, Poller B, Tabanca N, Pferschy-Wenzig E-M, Kunert O, Wedge DE, et al. Bioactive xanthones from the roots of Hypericum perforatum (common St John’s wort). J Sci Food Agric. 2011;91(3):428–34.  https://doi.org/10.1002/jsfa.4202.CrossRefGoogle Scholar
  52. 52.
    Chatterjee SS, Bhattacharya SK, Wonnemann M, Singer A, Müller WE. Hyperforin as a possible antidepressant component of Hypericum extracts. Life Sci. 1998;63(6):499–510.  https://doi.org/10.1016/S0024-3205(98)00299-9.CrossRefPubMedGoogle Scholar
  53. 53.
    •• Lyles JT, Kim A, Nelson K, Bullard-Roberts AL, Hajdari A, Mustafa B, et al. The chemical and antibacterial evaluation of St. John’s Wort oil macerates used in Kosovar traditional medicine. Front Microbiol. 2017;8:1639.  https://doi.org/10.3389/fmicb.2017.01639 This study provides a detailed look at the differences in the chemical makeup and biological activity of St. John’s Wort extracts, highlighting the important role that extraction methodologies can have on study outcomes. CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Gunpinar S, Kilic OA, Duran I, Tosun M, Firat T, Soyler G. Evaluation of the effect of topical Hypericum perforatum oil on excisional palatal wound healing in rabbits. J Investig Surg. 2018:1–10.  https://doi.org/10.1080/08941939.2018.1474980.
  55. 55.
    Altıparmak M, Eskitaşçıoğlu T. Comparison of systemic and topical Hypericum perforatum on diabetic surgical wounds. J Investig Surg. 2018;31(1):29–37.  https://doi.org/10.1080/08941939.2016.1272654.CrossRefGoogle Scholar
  56. 56.
    • Güneş S, Tıhmınlıoğlu F. Hypericum perforatum incorporated chitosan films as potential bioactive wound dressing material. Int J Biol Macromol. 2017;102:933–43.  https://doi.org/10.1016/j.ijbiomac.2017.04.080 This study demonstrates how botanical ingredients can be incorporated into wound dressings and evaluated both for antimicrobial and human cytotoxicity in vitro. CrossRefPubMedGoogle Scholar
  57. 57.
    Wölfle U, Seelinger G, Schempp CM. Topical application of St. John’s wort (Hypericum perforatum). Planta Med. 2014;80(02/03):109–20.  https://doi.org/10.1055/s-0033-1351019.CrossRefPubMedGoogle Scholar
  58. 58.
    Yücel A, Kan Y, Yesilada E, Akın O. Effect of St.John’s wort (Hypericum perforatum) oily extract for the care and treatment of pressure sores; a case report. J Ethnopharmacol. 2017;196:236–41.  https://doi.org/10.1016/j.jep.2016.12.030.CrossRefPubMedGoogle Scholar
  59. 59.
    Schempp CM, Winghofer B, Lüdtke R, Simon-Haarhaus B, Schöpf E, Simon JC. Topical application of St John’s wort (Hypericum perforatum L.) and of its metabolite hyperforin inhibits the allostimulatory capacity of epidermal cells. Br J Dermatol. 2002;142(5):979–84.  https://doi.org/10.1046/j.1365-2133.2000.03482.x.CrossRefGoogle Scholar
  60. 60.
    Lavagna SM, Secci D, Chimenti P, Bonsignore L, Ottaviani A, Bizzarri B. Efficacy of Hypericum and Calendula oils in the epithelial reconstruction of surgical wounds in childbirth with caesarean section Il. Farmaco. 2001;56(5):451–3.  https://doi.org/10.1016/S0014-827X(01)01060-6.CrossRefPubMedGoogle Scholar
  61. 61.
    Kamuhabwa A, Roelandts R, Witte P. Skin photosensitization with topical hypericin in hairless mice. J Photochem Photobiol B. 1998;53:110–4.CrossRefGoogle Scholar
  62. 62.
    Davids LM, Kleemann B, Kacerovska D, Pizinger K, Kidson SH. Hypericin phototoxicity induces different modes of cell death in melanoma and human skin cells. J Photochem Photobiol B. 2008;91(2–3):67–76.  https://doi.org/10.1016/j.jphotobiol.2008.01.011.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of DermatologyEmory University School of MedicineAtlantaUSA
  2. 2.Center for the Study of Human HealthEmory University College of Arts and SciencesAtlantaUSA
  3. 3.Emory University HerbariumAtlantaUSA

Personalised recommendations