Nutritional support for wound healing

Alternative Medicine Review, Nov, 2003 by Douglas J. MacKay, Alan L. Miller

Table 2 summarizes nutrients recommended for post-surgery or trauma care.

Botanical Medicines in Wound Healing

Centella asiatica and Aloe vera

Centella asiatica and Aloe vera have been used for decades as folk remedies for burns, wounds, and scars. Improved wound healing has been reported from topical or internal application of these two botanical medicines. Continued use of these plants as healing agents has led to scientific investigation of their efficacy as wound healing agents.

Centella asiatica (gotu kola) has been documented to aid wound healing in several scientific studies. (96-99) One of the primary mechanisms of action of Centella appears to be the stimulation of type-1 collagen production. (100) Animal studies have consistently shown topical application of Centella asiatica to a sutured wound significantly increased the breaking strength of the wound. (96,99,101,102) Asiaticoside, a saponin extracted from Centella asiatica, is thought to be one of its active constituents. Shukla et al showed a 0.2-percent asiaticoside solution applied topically twice daily for seven days to punch wounds in guinea pigs resulted in 56-percent increase in hydroxyproline, 57-percent increase in tensile strength, increased collagen content, and better epithelialization compared to controls. Using the same punch wound model the researchers demonstrated an oral dose of 1 mg/kg for seven days produced a 28-percent reduction in wound area and a significant increase of tensile strength and hydroxyproline content of the wound. (102)

Topical treatment with Aloe vera has been shown to improve healing in frostbite and electrical injury in animals. (103,104) In addition, Aloe vera has improved the healing of wounds in both normal and diabetic rats. (105,l06) Topical application and oral administration of Aloe vera to rats with healing dermal wounds increased the collagen content of the granulation tissue as well as the degree of cross-linkage. Collagen increased 93 percent with topical treatment and 67 percent with oral treatment compared to controls. The increase was attributed to increased stimulation by Aloe vera of collagen synthesis or increased proliferation of fibroblast synthesis of collagen, or both. (107) In a similar study, the effects of oral and topical Aloe vera on full thickness dermal wounds in rats exhibited an increase in glycosaminoglycan components of the extracellular matrix and, in particular, hyaluronic acid and dermatan sulphate levels. (107)

Aloe vera and Centella asiatica have been widely used for a host of curative purposes including facilitating wound repair. In spite of their wide use as folk remedies the biochemical basis for their action or influence on tissue repair is just beginning to be understood. Human clinical trials are needed to determine safety and benefits of perioperative oral administration of these botanicals. Topical application of both Aloe vera and Centella asiatica extracts to healing wounds or surgical scars appears to be safe and facilitates improved wound repair.