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The efficacy of Aloe vera used for burn wound healing: A systematic review
Abstract
Aloe vera has been traditionally used for burn healing but clinical evidence remains unclear. We conducted a systematic review to determine the efficacy of topical aloe vera for the treatment of burn wounds. We electronically searched relevant studies in MEDLINE, CINAHL, Cochrane Library, HealthSTAR, DARE, South-East Asia Database, Chinese Databases, and several Thai local Databases (1918-June 2004). Only controlled clinical trials for burn healing were included. There were no restrictions on any language of publication. Two reviewers independently extracted data on study characteristics, patient characteristics, intervention, and outcome measure. Four studies with a total of 371 patients were included in this review. Based on a meta-analysis using duration of wound healing as an outcome measure, the summary weighted mean difference in healing time of the aloe vera group was 8.79 days shorter than those in the control group (P=0.006). Due to the differences of products and outcome measures, there is paucity to draw a specific conclusion regarding the effect of aloe vera for burn wound healing. However, cumulative evidence tends to support that aloe vera might be an effective interventions used in burn wound healing for first to second degree burns. Further, well-designed trials with sufficient details of the contents of aloe vera products should be carried out to determine the effectiveness of aloe vera.
... Thus, A. vera is traditionally employed for medicinal and cosmetic purposes, taken internally to address digestive issues, asthma, diabetes, and periodontal diseases, and applied externally to treat skin conditions, burns, and promote healthy skin (Shrestha et al., 2015;Lanka, 2018). The traditional usage of A. vera for skin injuries and stomach disorders, based on its anti-inflammatory (Langmead et al., 2004;Yagi et al., 2002) antibacterial (Nejatzadeh-Barandozi, 2013;Danish et al., 2020), and wound healing (Davis et al., 1989;Maenthaisong et al., 2007) characteristics, has evolved into modern medicine through substantial research (Sánchez et al., 2020). ...
... Aloe vera exhibits various pharmacological properties (Table 1), such as anti-inflammatory (Langmead et al., 2004;Yagi et al., 2002) antibacterial (Nejatzadeh-Barandozi, 2013;Danish et al., 2020), and wound healing (Davis et al., 1989;Maenthaisong et al., 2007), antioxidant (Hu et al., 2003;Hęś et al., 2019), laxative (Manvitha and Bidya, 2014;Surjushe et al., 2008), immunomodulatory (Madan et al., 2008;Kwon et al., 2011), anti-diabetic (Tanaka et al., 2006;Atanu et al., 2018), skin protective (Foster, 1999;Gao et al., 2019) and potential anti-cancer effects (Karpagam et al., 2019;Murugesan et al., 2021) making it a versatile plant with medicinal potential. It has been employed in the pharmaceutical industry to manufacture topical drug products, ointments, gel preparations, tablets, and capsules (Manvitha and Bidya 2014). ...
... Aloin has been studied for its potential role in wound healing (Davis et al., 1987;Maenthaisong et al., 2007;Liang et al., 2021). A. vera is known to improve wound healing, as demonstrated by studies involving mice where it enhanced the healing process compared to control groups. ...
... 20 Aloe vera has gained popularity as a remedy for minor wounds and burns, although its precise mechanism of action in wound healing remains unknown. 20,21 Aloe vera is widely recognized for its beneficial effects on the skin, particularly in the context of wound healing, 21 and is commonly used as an ingredient in cosmetic and pharmaceutical products. 1,3 It has gained popularity in society as a remedy for skin issues like acne, burns, and itching. ...
... 20 Aloe vera has gained popularity as a remedy for minor wounds and burns, although its precise mechanism of action in wound healing remains unknown. 20,21 Aloe vera is widely recognized for its beneficial effects on the skin, particularly in the context of wound healing, 21 and is commonly used as an ingredient in cosmetic and pharmaceutical products. 1,3 It has gained popularity in society as a remedy for skin issues like acne, burns, and itching. ...
... Therefore, it is recommended to conduct further trials with larger sample sizes to gather more conclusive evidence on the use of Aloe vera dressings for medium burns. 6,21 Centella asiatica Centella asiatica (also known as Gotu Kola) belongs to the Apiaceae family. This plant holds significant traditional value, particularly in Southeast Asia, due to its nutritional and therapeutic properties. ...
Introduction and aim. The World Health Organization (WHO) reports that around 11 million people experience burn injuries each year.1,2 Burn injuries occur when tissue damage is caused by various factors such as UV radiation, heat, chemicals, or electric current.3,4 While burns primarily affect the skin, they can also extend to deeper tissues like bones or muscles. When the skin is burned, its vital functions, including protection against the external environment, pathogens, and evaporation, are compromised.1 The appropriate treatment method must be chosen based on the burn stage, the patient's condition, and the cause. The aim of this paper is to provide a comprehensive review based on literature, concerning superficial burns and sunburns treatment, with a focus on nature-derived topical treatment methods. Material and methods. PubMed database was searched for the following terms: “burns”, “burn treatment”, “aloe vera”, “sunburn”, “centella asiatica”, “climate change”, “wound healing” for the articles published between 2005-2023 and written in the English language. Conclusion. Herbal-derived compounds, with their diverse mechanisms of action, antibacterial activity, and safety profiles present a competitive alternative to conventional treatment of burns and sunburns, however, there are still not enough clinical trials to assess the effectiveness and safety profiles of nature-derived compounds.
... Not surprisingly, several systematic reviews and metaanalyses have been published with regard to aloe vera and wound healing. 32,[51][52][53][54][55][56] Despite this, there is ongoing uncertainty regarding the true effect of aloe vera on various types of medical conditions, particularly in reference to second-degree burns. There are many potential contributors to this inconclusiveness. ...
... Some systematic reviews were conducted on studies that were not blinded, which reduced the validity of the results of the trials, and very few reviews include a meta-analysis. 52,53 Other reviews, such as one by Moore and Cowman, 54 were performed on studies that had small sample sizes, making it difficult to assess statistical significance. Another factor contributing to the uncertainty of aloe vera's wound healing capacity could also be the absence of a broadly accepted treatment protocol. ...
... The amount of active ingredients in aloe varies, depending on the age of the plant when it was harvested. 53 Studies use different concentrations of aloe as well as different mediums, such as gel, cream, mouth washes, juices, and other forms. ...
Objective:
Aloe vera is a cost-effective, accessible wound care adjunct with a minimal risk profile. Despite its centuries-long history being used to treat varying wound types, published reports remain inconclusive on its efficacy. In this article, the authors report the results of a systematic review assessing the efficacy of topical aloe vera products in wound care applications, as well as a meta-analysis of its utility in burn healing where data are most robust.
Data sources:
In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the authors searched PubMed, EMBASE, and Cochrane CENTRAL for randomized controlled trials assessing the use of aloe vera in healing various wound types.
Study selection:
The database search identified 91 articles. After duplicates were removed, 74 articles were screened, and of those, 47 were assessed for eligibility. Ultimately, 28 articles were included in the qualitative synthesis, and 4 studies assessing second-degree burns were included in the meta-analysis.
Data extraction:
The following data points were collected from each study: number of participants/wounds, treatment type, adjunctive therapy (if any), and primary outcomes.
Data synthesis:
Risk-of-bias analysis was conducted on included articles, and results were compiled. A meta-analysis was undertaken for studies focusing on the treatment of burns. Cumulatively, these studies had a total of 133 patients with 163 wounds being assessed. Analysis revealed a statistically significant mean difference in time to healing of 4.44 days in favor of aloe vera treatment (P = .004).
Conclusions:
Topical aloe vera usage for second-degree burn wound healing demonstrated significantly faster time to healing compared with other treatments.
... The body of evidence identified in the search included eight studies, 6-13 most of which were summarised in two systematic reviews, 4,5 and all of which were at moderate or high risk of bias. All the research was conducted in people with partial thickness (second-or third-degree burns). ...
... 6,7 Participants had deep partial thickness (second-or third-degree) burns to up to 40% of total body surface area. 4 The pooled results for two studies 7, 12 reporting time to complete healing showed that aloe vera products were associated with superior outcomes compared to control treatments. Time to complete healing was statistically significantly shorter for topical aloe vera compared to the comparator treatments (weighted mean difference [WMD] 8.79 days, 95% confidence interval [CI] 2.51 to 15.07, p = 0.006). ...
... mm) (Level 1). 4 A Cochrane review 5 included three studies 6-8 reporting aloe vera treatments for people with burns, two of which are reported above. 6,7 In the third study (also at high risk of bias), 8 Efficacy of aloe vera gel for deep partial thickness burns was demonstrated in an RCT conducted in individuals with second degree burns covering less than 25% total body surface area. ...
... 2 The extract of aloe vera gel allowed for quicker healing of burns and restored the vascularity of burn tissues. These effects could be the result of a number of mechanisms, such as an increase in the production of collagen and the rate of epithelialization brought on by the ability of acemanan (mannose-6 phosphate) to stimulate fibroblasts, as well as an anti-inflammatory, antimicrobial, and moisturizing effect (Maenthaisong et al. 2007). 3 One of the main benefits of using aloe vera gel in many nations is the healing of burn wounds. ...
... These effects could be the result of a number of mechanisms, such as an increase in the production of collagen and the rate of epithelialization brought on by the ability of acemanan (mannose-6 phosphate) to stimulate fibroblasts, as well as an anti-inflammatory, antimicrobial, and moisturizing effect (Maenthaisong et al. 2007). 3 One of the main benefits of using aloe vera gel in many nations is the healing of burn wounds. [4][5] Burns have been identified as one of the most damaging types of child damage in terms of functional, social, and psychological impact. ...
Background: Aloe vera has been used traditionally for healing burn and inflammation. Though, the evidence for the effectiveness of aloe vera for healing burn is not sufficient. Objective: The aim of this study was to assess the effectiveness of aloe vera gel in management of superficial burn in children. Methods: This retrospective study was taken place in the Department of Burn and Reconstructive Surgery, Bangladesh Shishu Hospital & Institute, Dhaka and other two privet clinics at Dhaka, from September, 2019 to March, 2022. Total 47 patients with superficial partial thickness burn was included in the study. Results: In this study, majority (48.94%) patients were belonged to the age group of £24 months. The mean age was found 38.9±26.31 months. The current study observed that almost two third (61.70%) patients were male. In our study, majority (63.83%) patients stayed hospital for 1-5 days. In the present study, mean (±SD) pain relief time was 3.56±1.24 days and mean (±SD) wound healing time was found 8.19±1.6 days. The current study observed that only 3(6.38%) patients had found wound infection. In current study showed that mean treatment cost was found 76.46±31.88 Taka. Conclusion: Aloe vera gel facilitated early pain alleviation, wound healing, and costeffective superficial burn treatment in children. Therefore, it can be utilized to treat superficial burns in children to get better results. DS (Child) H J 2021; 38(1): 39-43
... Balaji et al. (2015) reviewed biomaterials-based nano-applications of Aloe vera and its perspective. Maenthaisong et al. (2007) reviewed the efficacy of Aloe vera used for burn wound healing. Khanzada et al. (2020) investigated the fabrication of promising antimicrobial Aloe vera/PVA electrospun nanofibers for protective clothing. ...
... Despite their shortcomings, natural antimicrobials pose no risk to humans and the environment, unlike synthetic antimicrobials that are environmentally unfriendly and can be toxic to humans. A natural antimicrobial is biocompatible and does not induce an immune response (Maenthaisong et al. 2007;Mohseni et al. 2019). The antimicrobial quaternary ammonium salt suppresses microbial growth when applied to wounds; however, it causes hemolysis of red blood cells (Gharibi et al. 2019). ...
Natural wound dressings extracted from Aloe vera leaves have gained greater recognition in the treatment of wounds due to their ability to accelerate wound healing and their nontoxic nature for humans and the environment. Treated wound dressing allows the removal of moisture and movement of gases to and from the wound area while the antimicrobial agent in it suppresses microbial growth. Extracted Aloe vera components can be applied directly into a fabric or they can be electrospun to nanoparticles that are incorporated into the fabric. Because biological antimicrobial agents like Aloe vera are not highly effective against high concentrations of microorganisms, chemical antimicrobial agents are still used even though they are harmful. Processing Aloe vera using methods like the thermal treatment method makes the Aloe vera lose some of its therapeutic benefits. Natural fabrics treated with Aloe vera can be used as an alternative to chemical agents used for wound treatment. Natural wound dressings treated with natural antimicrobial agents have the advantage of preventing microbial growth while at the same time promoting wound healing without activating the immune response as they are biocompatible.
... Thus, A. vera is useful in accelerating wound healing and increasing the rate of healing success and the degree of epithelialization in first and second burns. 16 Furthermore, the efficacy of A. vera cream in the treatment of second-degree burns was compared to silver sulfadiazine cream, with A. vera healing partial thickness burns significantly faster and with greater efficacy than silver sulfadiazine. The antibacterial, cell Proliferative, and anti-inflammatory properties of A. vera may explain the rapid re-epithelialization of skin in patients. ...
... Collaborators in data collection Mariam Salah Moris, 1 Amany Eid Mahfouz, 2 Aseel Maher El-Helou, 3 Aya Osama Al-Nabahin, 4 Banan Hashem El-Haj Yousef, 5 Dina M. El-Sherif, 6 Eman Mostafa Ahmad Elbakry, 7 Eman Rezeq Al-Baba, 8 Fatima Fawzi Abd Elslam, 9 Hasan M_ Masoum Hamoud, 10 Maysa madny mahmoud, 11 Noha Nabil Al-aqqad, 12 Ruba Rateb Almnashef, 13 Sara Ibrahim Bader, 14 Sara Motawea, 15 Yusra Talal Alnasser, 16 ...
Traditional healers are often practiced in rural areas due to cultural beliefs and are known to provide various forms of healthcare and home remedies. Patients in the Mediterranean region rely on traditional medicine to cure a variety of health concerns, like skin burns. This study was conducted to identify the various practices used by traditional healers for treating skin burns. The survey was conducted in eighteen Arab countries, including Syria, Iraq, Jordan, Saudi Arabia, Egypt, United Arab Emirates, Algeria, Bahrain, Palestine, Kuwait, Oman, Qatar, Lebanon, Yemen, Tunisia, Oman, Morocco, and Sudan. Between September 2020 and July 2021, an online questionnaire was administered to 7,530 participants from twelve Asian and five African countries. The survey was designed to gather information from common medicinal plant users and herbalists on their practices as specialists in using various herbal and medicinal plant products for diagnosis and treatment. Among the participants, 2,260 had a scientific background in plant application, and the study included one phytotherapeutic professional. The crude-extraction technique was favoured, by Arabic folk, for plant preparation over the maceration and decoction method. Olive oil was the most commonly utilized product among participants as an anti-inflammation and for scar reduction. A. vera, olive oil, sesame, C. siliqua, lavender, potato, cucumber, shea butter, and wheat flour are used as crude drugs to reduce pain because of their analgesic and cooling effects.
The present study is the first database of medicinal plants with burn-healing properties conducted in Arab countries. These plants can be employed in the search for new bioactive substances through pharmacochemical investigations, as well as in the development of new formulations containing a combination of these plants.
... It is cultivated in warm climatic areas of the world. Aloe vera (AV) has been known as "secret plant" because it contains photochemical, vitamins and nutrients [1]. This plant has elongated, pointed and fleshy leaves which consists of two parts, an outer skin (green rind or latex) and an inner pulp which is colorless mucilaginous gel [2,3]. ...
... first and second burns. 9 Aloe vera has mending properties such as Glucomannan, a mannoserich polysaccharide, and gibberellin, a development hormone, interatomic with development calculate receptors on the fibroblast, subsequently invigorating its movement and expansion, which in turn altogether increments collagen amalgamation. Moreover has antiinflammatory activity hinders the cyclooxygenase pathway and diminishes prostaglandin E2 generation from arachidonic corrosive and from compound like C-glucosyl chromone was separated from gel extricates. ...
Introduction: Chemical burns are injuries to the oral mucosa caused by the application of corrosive topical materials. Chemical trauma or chemical burns are one cause of mouth ulcers. Cutaneous and perioral skin chemical burn clinically, erythema, burning sensation, edema, desquamation, and ulcers. Case: A 6-year-old child patient complained of a burning sensation in the corner of the left lip during a treatment of root canal treatment using cresophene. Treatment: Patient was given a topical application of aloe vera extract dental gel, and was prescribed the same drug. Discussion: Cresophene is an antimicrobial agent used for infected root canal treatment. Cresophene is an agent antimicrobial class of phenol compounds, because it contains phenol, cresophene have antibacterial activity especially on group of gram positive bacteria. The clinical appearance of chemical burns depends on the severity of the tissue damage, the destructive properties, and mode of application of the causative agent. Aloe vera taken in a variety of dosage forms may be useful in accelerating the wound healing process and tend to raise the rate of success of healing and the rate of epithelialization in first and second burns.
... Royal jelly is a concentrated milky liquid consisting of 67% water, 12.5% protein, 11% sugar, and 5% acids, vitamins, enzymes, antibacterial compounds, and antibiotics (Weaver & Weaver, 2003). There is evidence that this substance has antioxidant, antitumor, antimicrobial, and neurogenesis properties (Nakaya et al., 2007;Ito et al., 2012;Park et al., 2012;Hattori et al., 2007;Maenthaisong et al., 2007). Aloe Vera is a herb with proven healing and therapeutic effects. ...
In recent decades, effective herbal and natural compounds have been formulated
with topical application, reduced side effects, and more economic benefits for
Cutaneous Leishmaniasis (CL) treatment. Some of these include Propolis, Royal
jelly, Ostrich oil, and Aloe Vera, which have widespread use in health products.
The study aimed to evaluate the potential therapeutic effects of a prepared topical
combination, including Propolis, Royal jelly, Ostrich oil, and Aloe Vera, on
Leishmania major lesions under an in vivo model in BALB/c (concatenation of
Bagg and Albino) mice.
... The anti-inflammatory effects and increased collagen production and cross-linking promote the rearrangement of epithelial tissues [12], reducing the wounded area and accelerating the healing process [170]. Various studies have confirmed that topical AV creams heal first-and second-degree burns in less than half the time than standard treatment with silver sulfadiazine [21,[171][172][173]. AV has an anti-erythema activity similar to that of the positive control group (i.e., hydrocortisone gel) after 6 days of treatment [174]. ...
Aloe vera-based hydrogels have emerged as promising platforms for the delivery of therapeutic agents in wound dressings due to their biocompatibility and unique wound-healing properties. The present study provides a comprehensive overview of recent advances in the application of Aloe vera-based hydrogels for wound healing. The synthesis methods, structural characteristics, and properties of Aloe vera-based hydrogels are discussed. Mechanisms of therapeutic agents released from Aloe vera-based hydrogels, including diffusion, swelling, and degradation, are also analyzed. In addition, the therapeutic effects of Aloe vera-based hydrogels on wound healing, as well as the reduction of inflammation, antimicrobial activity, and tissue regeneration, are highlighted. The incorporation of various therapeutic agents, such as antimicrobial and anti-inflammatory ones, into Aloe vera-based hydrogels is reviewed in detail. Furthermore, challenges and future prospects of Aloe vera-based hydrogels for wound dressing applications are considered. This review provides valuable information on the current status of Aloe vera-based hydrogels for the delivery of therapeutic agents in wound dressings and highlights their potential to improve wound healing outcomes.
... The anti-inflammatory effects and increased collagen production and cross-linking promote the rearrangement of epithelial tissues [12], reducing the wounded area and accelerating the healing process [170]. Various studies have confirmed that topical AV creams heal first-and second-degree burns in less than half the time than standard treatment with silver sulfadiazine [21,[171][172][173]. AV has an anti-erythema activity similar to that of the positive control group (i.e., hydrocortisone gel) after 6 days of treatment [174]. ...
Aloe vera-based hydrogels have emerged as promising platforms for the delivery of therapeutic agents in wound dressings due to their biocompatibility and unique wound-healing properties. The present study provides a comprehensive overview of recent advances in the application of Aloe vera-based hydrogels for wound healing. The synthesis methods, structural characteristics, and properties of Aloe vera-based hydrogels are discussed. Mechanisms of therapeutic agents released from Aloe vera-based hydrogels, including diffusion, swelling, and degradation, are also analyzed. In addition, the therapeutic effects of Aloe vera-based hydrogels on wound healing, as well as the reduction of inflammation, antimicrobial activity, and tissue regeneration, are highlighted. The incorporation of various therapeutic agents, such as antimicrobial and anti-inflammatory ones, into Aloe vera-based hydrogels is reviewed in detail. Furthermore, challenges and future prospects of Aloe vera-based hydrogels for wound dressing applications are considered. This review provides valuable information on the current status of Aloe vera-based hydrogels for the delivery of therapeutic agents in wound dressings and highlights their potential to improve wound healing outcomes.
... Aloe vera (Alo) belongs to the Liliaceae family and its mucilaginous tissue (Alo gel) has been used to produce various medicinal products [20]. Alo gel is colorless and consists of polysaccharides such as cellulose, glucomannan, pectin, acemannan and mannose derivatives. ...
To more closely resemble the structure of natural skin, multi-layered wound dressings have been developed. Herein, a tri-layer wound dressing was prepared containing a polyacrylamide (PAAm)-Aloe vera (Alo) sponge that had been incorporated with insulin-like growth factor-1 (IGF1) to provide a porous absorbent layer, which was able to promote angiogenesis. Alo nanofibers with multi-walled carbon nanotubes (MWCNT) were electrospun into the bottom layer to increase cell behavior, and a small film of stearic acid was put as a top layer to avoid germy penetration. In comparison to bilayer dressing, the tensile strength increased by 17.0 % (from 0.200 ± 0.010 MPa to 0.234 ± 0.022 MPa) and the elastic modulus by 45.6 % (from 0.217 ± 0.003 MPa to 0.316 ± 0.012 MPa) in the presence of Alo nanofibers containing 0.5 wt% of MWCNT at the bottom layer of Trilayer0.5 dressing. The release profile of IGF1, the antibacterial activity and the degradability of different wound dressings were investigated. Trilayer0.5 indicated the highest cell viability, cell adhesion and angiogenic potential among the prepared dressing materials. In-vivo rat model revealed that the Trilayer0.5 dressing treated group had the highest rate of wound closure and wound healing within 10 days compared to other groups.
... Aloe vera juice is used for consumption and relief of digestive issues such as heartburn and irritable bowel syndrome, although it bears significant potential to be toxic when taken orally [30]. Other uses for extracts of aloe vera include the dilution of semen for the artificial fertilization of sheep [32], use as fresh food preservative [33], and use in water conservation in small farms [34]. [44]. ...
Plants has ever been an important part of human life in different ways. Number of herbals has been listed for their medicinal and cosmetics values. We can never miss out their role in the treatment of several diseases. Moreover, the plant based medicines has also being used for untreatable disease as there is no other option except them. Researchers are trying for the renaissance of the medicinal properties of herbals for different ailments. These work should brought in the notice of each concern man. Present work is therefore focused on the review of literature on Aloe vera and turmeric.
... Outros estudos elucidaram bem as atividades antidiabética e hipogliceimiante da planta (GUPTA et al., 2011;LANJHIYANA et al., 2011;SHAHRAKI et al., 2009), encontrando melhora significativa da insulina plasmática em animais portadores de diabetes e redução significativa da glicose de jejum, além de melhora importante nos parâmetros que revelam distúrbios no metabolismo de lipídios, pela diminuição de colesterol, triglicérides, ácidos graxos livres e fosfolipídios em animais submetidos ao tratamento com o extrato em gel de Aloe vera (RAJASEKARAN et al., 2006). O potencial cicatrizante (FALEIRO et al., 2009;MAENTHAISONG et al., 2007;OLIVEIRA et al., 2010) foi evidenciado em muitos estudos, através da maior recuperação na contração das feridas nos experimentos realizados com esse vegetal, comparando-o com o placebo ou com outros tipos de cicatrizantes. ...
Aloe vera é considerada a espécie mais biologicamente ativa e comercializada do gênero Aloe L. e vem sendo utilizada há muito tempo com finalidade terapêutica, devido às propriedades antiinflamatórias e antibacterianas de substâncias ativas que estão concentradas no gel e na casca das folhas de Aloe vera. O presente artigo teve como objetivo revisar a utilização da planta Aloe vera como fim terapêutico, descrevendo as aplicações clínicas, e contemplar relatos de toxicidade em relação ao uso não tópico da planta em uma revisão crítica de artigos sobre o tema, publicados principalmente em revistas indexadas nas bases de dados da SCIELO, BIREME e LILACS. Foram observadas as mais variadas aplicações clínicas da planta Aloe vera, como diminuição dos níveis de açúcar no sangue e de colesterol, anti-inflamatório, potente cicatrizante, anticâncer, antimicrobiano, dentre muitas outras. Algumas pesquisas mostraram alguns efeitos indesejáveis do uso desse vegetal em doses elevadas e dependendo da forma de administração. Entretanto, em doses aceitáveis, há corroboração científica de benefícios ao organismo em diferentes condições clínicas. A Agência Nacional de Vigilância Sanitária (Anvisa) respalda o uso de produtos a base de Aloe vera, tanto como medicamentos para fins cicatrizantes, como em bebidas a base dessa planta. Dessa forma, o profissional de saúde fica amparado para a utilização racional desses produtos, a fim de se obter os benefícios desejados.
... Silver sulfadiazine is used to prevent the microbial contamination of the burn site but impairs wound healing [116]. Given the long history associated with the use of A. vera on minor burns, there was validity in the assessments; a systematic review indicated a reduction in the healing time of burn injuries following A. vera treatment [117]. The clinical study by Khorsani et al. (2009) demonstrated this reduction in healing time following A. vera application when compared to silver sulfadiazine; all 30 patients (100%) in the A. vera group, compared to 80% of the silver sulfadiazine group, demonstrated complete wound healing with 19 days [116]. ...
Chronic, non-healing wounds represent a significant area of unmet medical need and are a growing problem for healthcare systems around the world. They affect the quality of life for patients and are an economic burden, being difficult and time consuming to treat. They are an escalating problem across the developed world due to the increasing incidence of diabetes and the higher prevalence of ageing populations. Effective treatment options are currently lacking, and in some cases chronic wounds can persist for years. Some traditional medicines are believed to contain bioactive small molecules that induce the healing of chronic wounds by reducing excessive inflammation, thereby allowing re-epithelisation to occur. Furthermore, many small molecules found in plants are known to have antibacterial properties and, although they lack the therapeutic selectivity of antibiotics, they are certainly capable of acting as topical antiseptics when applied to infected wounds. As these molecules act through mechanisms of action distinct from those of clinically used antibiotics, they are often active against antibiotic resistant bacteria. Although there are numerous studies highlighting the effects of naturally occurring small molecules in wound-healing assays in vitro, only evidence from well conducted clinical trials can allow these molecules or the remedies that contain them to progress to the clinic. With this in mind, we review wound-healing natural remedies that have entered clinical trials over a twenty-year period to the present. We examine the bioactive small molecules likely to be in involved and, where possible, their mechanisms of action.
... La necesidad analgesia disminuye considerablemente cuando se inicia la epitelización. 29,30 Quimioprofilaxis La superficie corporal quemada es propensa a la rápida colonización de bacterias, con el potencial de infección; sin embargo, en quemaduras menores en epidermis intacta, rara vez se inician una infección y no es necesaria la indicación de antibióticos tópicos. 31 Estas heridas solo requieren la aplicación de crema hidratante, sin perfume, o una gasa empapada con bismuto. ...
ANTECEDENTES: las quemaduras en genitales y periné ocurren en un grupo pequeño de pacientes que requieren diagnósticos precisos, tratamiento intensivo y oportuno por parte de equipos multidisciplinarios. Las quemaduras en los genitales representan, aproximadamente, 2% de todas las series estadounidenses de quemados. En la mayor parte de los casos se asocian con una gran superficie corporal quemada; el fuego directo y la escaldadura son las causas más frecuentes. El tratamiento de las quemaduras se inicia con el diagnóstico oportuno; para ello deben clasificarse correctamente según la profundidad de la lesión. Después de establecido el diagnóstico, el tratamiento debe ser intenso y dirigido a evitar la profundización de la quemadura. La reanimación hídrica es el paso inicial seguida de curaciones, cuando se trata de quemaduras superficiales. En quemaduras de segundo grado profundo o tercer grado, la reconstrucción dependerá de la afectación. Entre las opciones de reconstrucción destacan: aplicación de injertos cutáneos, colgajos locorregionales, colgajos libres y, en casos graves, reconstrucción total del pene. Las complicaciones dependen de la extensión de la quemadura. Las quemaduras en los genitales y periné representan un reto diagnóstico y terapéutico para el urólogo.Palabras clave: reconstrucción en quemados, quemaduras genitales, reconstrucción genital
... AV has been successfully used to prevent skin ulcers and treat burn wounds, postoperative wounds, and chronic wounds, such as pressure ulcers. AV has also been reported to heal first-and second-degree burns [13]. AV's antiinflammatory and anti-bacterial features contribute to its potent wound-healing properties. ...
Burn wounds remain a prevalent problem in the developed and developing world. A multitude of remedies has been tested. This study evaluated the healing time of second- and third-degree burn wounds between silver sulfadiazine (SSD) and Aloe vera (AV). In July 2020, a systematic review of MEDLINE (Ovid) and PubMed (National Library of Medicine) was performed to identify studies that reported healing of second- and third-degree burns using either SSD or AV. Articles meeting the inclusion criteria were screened and carefully analyzed. Our goal was to report the healing time for these burns using SSD and AV. A total of eight studies published between 1988 and 2018 reporting healing of second- and third-degree burns using SSD and AV were included in this review. Six were cohort studies and two were randomized controlled trials. The studies included both animal and human subjects. The meta-analysis demonstrated that the mean time to wound healing favored AV (RR: -1.34, 95% CI: -1.8 to 0.9, p < 0.001). It would seem that time to healing benefitted those burns in which AV was utilized. In conclusion, increased consideration and emphasis should be placed on using AV to aid the healing of second- and third-degree burns.
... Other clinical trials were performed with the purpose to evaluate the wound healing potential of A. vera. The study performed by Maenthaisong et al. (2007b) showed that this plant presents an important curative effect in first-and second-degree burn wounds and accelerates the process of healing to 9 days. Furthermore, some other studies have been reported on the clinical evidence of using A. vera in skin ulcers, and postoperative wounds (Molazem et al., 2015;Eshghi et al., 2010). ...
Ethnopharmacological relevance
The human skin constitutes a biological barrier against external stress and wounds can reduce the role of its physiological structure. In medical sciences, wounds are considered a major problem that requires urgent intervention. For centuries, medicinal plants have been used in the Mediterranean countries for many purposes and against wounds.
Aim of this review
Provides an outlook on the Mediterranean medicinal plants used in wound healing. Furthermore, the wound healing effect of polyphenolic compounds and their chemical structures are also summarized. Moreover, we discussed the wound healing process, the structure of the skin, and the current therapies in wound healing.
Materials and methods
The search was performed in several databases such as ScienceDirect, PubMed, Google Scholar, Scopus, and Web of Science. The following Keywords were used individually and/or in combination: the Mediterranean, wound healing, medicinal plants, phenolic compounds, composition, flavonoid, tannin.
Results
The wound healing process is distinguished by four phases, which are respectively, hemostasis, inflammation, proliferation, and remodeling. The Mediterranean medicinal plants are widely used in the treatment of wounds. The finding showed that eighty-nine species belonging to forty families were evaluated for their wound-healing effect in this area. The Asteraceae family was the most reported family with 12 species followed by Lamiaceae (11 species). Tunisia, Egypt, Morocco, and Algeria were the countries where these plants are frequently used in wound healing. In addition to medicinal plants, results showed that nineteen phenolic compounds from different classes are used in wound treatment. Tyrosol, hydroxytyrosol, curcumin, luteolin, chrysin, rutin, kaempferol, quercetin, icariin, morin, epigallocatechin gallate, taxifolin, silymarin, hesperidin, naringin, isoliquiritin, puerarin, genistein, and daidzein were the main compounds that showed wound-healing effect.
Conclusion
In conclusion, medicinal plants and polyphenolic compounds provide therapeutic evidence in wound healing and for the development of new drugs in this field.
... Rathee, Kamboj, and Sidhu 2016) Ekstrak lidah buaya, antara lain mengandung mineral, vitamin, asam amino, sakarida, enzim, lignin, antrakuinon, asam salisilat, dan saponin. Telah diidentifikasi dan dievaluasi zat yang bertanggung jawab atas efek terapi yang dimiliki lidah buaya, namun adanya interaksi sinergis antara senyawa bertanggung jawab atas efek terapinya, (Maenthaisong et al. 2007) contoh lain adalah Ektrak Manjistha (Rubia cordifolia Linn.) sebagai sumber penghasil antrakuinon. (P. ...
Penggunaan obat tradisional dalam memelihara kesehatan telah dilakukan sejak zaman dahulu hingga saat ini. Banyak ekstrak tumbuhan telah diketahui komposisi kimia dan efek terapeutiknya. Namun keterbatasan dari phytokonstituen seperti kelarutan dan masalah penyerapan yang rendah, dan ukuran molekul yang besar membatasi penyerapannya melintasi membran lipid biologis. Sehingga berdampak pada biovailabilitas yang rendah. Fitosom merupakan teknologi yang diperkenalkan untuk mengatasi rendahnya penyerapan bahan aktif alam, sehingga terjadi peningkatan bioavailabilitas karena peningkatan kemampuannya untuk melintasi membran seluler dan masuk ke dalam sirkulasi darah. Tinjauan ini bertujuan untuk memaparkan fitosom dalam system penghantaran obat terutama fitokonstituen beserta metode formulasi fitosom-fitokonstituen dan karakterisasinya. Metode penguapan pelarut meliputi jumlah ekstrak dan fosfolipid dengan rasio perbandingan 1:1, 1:2, 1:3 dilarutkan dalam pelarut organik lalu dilakukan reflux untuk menguapkan pelarut, residu yang dihasilkan ditambahkan pelarut non polar, disaring dan dikeringkan lalu disimpan di suhu kamar. Metode Hidrasi Lapis tipis meliputi persiapan kompleks ekstrak-fitosom dengan jumlah rasio 1:5 ditambahkan pelarut polar, diaduk dengan stirrer lalu pelarut diuapkan dengan rotary evaporator, lapisan film yang terbentuk ditambahkan buffer lalu di-ultasonikasi dan didinginkan selama maksimal 24 jam.
... Research has shown positive effects on wound healing of products derived from A. vera. Those are attributed to nutrient maintenance, humidity, oxygenation, inflammation control, immunoactivity, epithelialization and fibroblast proliferation [17][18][19][20][21]. ...
The Aloe vera (L.) Burman f. pulp extract (AE), obtained from the inner parts of Aloe vera leaves, is rich in polysaccharides, including glucomannans, acemannans, pectic compounds, cellulose, and hemicelluloses; acemannan and glucomannan are considered the two main components responsible for most of the plant’s therapeutical properties. Besides having anti-inflammatory activity, these polysaccharides accelerate wound healing and promote skin regeneration, thus they can be utilized in healing products. The objective of this study was to develop Aloe vera mucilaginous-based hydrogels for topical use in psoriasis treatment. The hydrogels were prepared with 80% w/w of A. vera mucilaginous gel, evaluating two distinct polymers as the gelling agent: 1% carbopol 940 (FC1 and FC2) or 2% hydroxyethylcellulose (FH3 and FH4). FC1, FC2, FH3 and FH4 were evaluated for their organoleptic characteristics, rheological properties, pH and glucomannan content. Polysaccharide fractions (PFs) were extracted from the AE and used as a group of chemical markers and characterized by infrared (IR) spectroscopy and 1H nuclear magnetic resonance (1H NMR). The quantification of these markers in the raw material (AE) and in the hydrogels was carried out using spectrophotometric techniques in the UV-VIS region. The hydrogels-based hydroxyethylcellulose (FH3 and FH4) had glucomannan contents of 6.76 and 4.01 mg/g, respectively. Formulations with carbopol, FC1 and FC2, had glucomannan contents of 8.69 and 9.17 mg/g, respectively, an ideal pH for application on psoriasis, in addition to good spreadability and pseudoplastic and thixotropic behavior. Considering these results, hydrogel FC1 was evaluated for its keratolytic activity in a murine model of hyperkeratinization. For that, 0.5 mL of test formulations FC1 and FPC (0.05% clobetasol propionate cream) were topically applied to the proximal region of adult rats daily for 13 days. After euthanasia, approximately 2.5 cm of the proximal portion of each animal’s tail was cut and placed in 10% buffered formalin. Then, each tail fragment was processed and stained with hematoxylin and eosin (HE), and the results obtained from the histological sections indicated a 61% reduction in stratum corneum for animals treated with the A. vera hydrogel (FC1G) and 66% for animals treated with clobetasol propionate (PCG), compared to the group of animals that did not receive treatment (WTG). This study led to the conclusion that compared to the classic treatment (clobetasol propionate), the 80% A. vera hydrogel showed no significant difference, being effective in controlling hyperkeratinization.
... Effects on pores and skin exposure to UV and X-radiation: aloe vera facilitates the recovery of first to the 2nd degree burns even though the precise characteristic isn't always extensively recognized [18]. It is the usually recommended that lection can be accountable for the therapeutic effect. ...
In the present study upon experiment was conducted where the influence of sunlight on the Growth and Yield of aloe Vera plant in summer. A pot experiment was performed in sindh agriculture university tando jam, sindh, Pakistan, during the period from march 2022 to June 2022 to quantify the influence of sunlight on growth and yield of aloe vera plant in summer to different shadows. The trial was laid out at Sindh Agriculture University, Tando jam, Sindh, Pakistan. The plants about 3 months olds of aloe vera plant were transplanted in earthen pots and placed at different shadows, T0 plant kept at sunlight, T1 plant kept in shadow, and T2 aloe vera plant was kept in sunlight for 5 to 7 hours. Outcomes found out that the tremendous variant was found for the special increase contributing characters of aloe vera plant in summer due to T2 aloe vera plant was kept in sunlight for 5 to 7 hours. The highest length of leaves about (18 inches), greatest number of leaves per plant (16), greatest number of suckers / plant (7), and highest wirth of leaf of aloe Vera (4 inches), highest weight of leaf (335 g), highest weight of leaf gel (275 g) was found from the (T2), Alternatively, the lowest length of leaves (13 inches), or lowest number of leaves (12), lowest number of suckers per plant (4), and the lowest worth of leaves (3.2 inches), lowest weight of leaf (290 g), lowest weight of leaf gel (145 g) result was observed from the T0 plant kept at sunlight, and middle results was observed from the T1 such as the length of leaves (14.4 inches), number of leaves (14), number of suckers per plant (5), and wirth of leaf (3.4 inches), weight of leaf (300 g), weight of leaf gel (200 g).
... formulations with threedimensional networks of organic systems comprising fluids and pharmaceuticals have been referred to as gels in the past. These technologies were primarily used in the old system of topical medication delivery for local effects [4]. With these preparations, it's possible that focused drug delivery won't be possible [8]. ...
Background: In permeation of drug, size of drug plays a very important role as size of dug as much as smaller, it become very easy to permeate so that researchers attract towards making size in nano range. Silver sulfadiazine on of the drug which is very useful in the treatment of burn. Many processes are adapted to make nanoparticles of this drug but the promising method of preparation of NPs of this drug is still vacant. Objectives: Development of silver sulfadiazine loaded Nano gel by using Noveon polycarbophil AA-1 as gelling agent in the treatment of burn infections. Method: First of all, nanoparticle of silver sulfadiazine was prepared by Modification Emulsification method. Then a gel was prepared by using Noveon polycarbophil AA-1 as gelling agent and varying homogenization time. Prepared formulations were subjected to evaluation accordance with standard Nano gel. Result: The formulation of Nano gel of silver sulfadiazine was prepared successfully and evaluation data were found at satisfactory level. In order to obtain particle size in Nano range, Noveon polycarbophil AA-1 was used for modification emulsification method in which at 0.75% concentration found to bring Nano size of particle in the range 10 to 200 nm. Formulation was evaluated for % drug entrapment efficiency, cumulative % drug release, spreadability, homogeneity. pH, clarity of gel etc. All the results were found in limit and showed satisfactory level of formulation for FG-5. Conclusion: Silver sulfadiazine loaded Nano gel by using Noveon polycarbophil AA-1 by modification emulsification method and optimum homogenization time would be very promising approach and convenient economically. Keywords: Silver sulfadiazine, loaded, nanogel, burn, Noveon polycarbophil AA-1.
... As previously been uncovered, the gel extract of the aloe vera (Aloe barbadensis Miller) plants promotes the healing process in the case of a burn, wound, and frost-bite, besides possessing antifungal, antiinflammatory, hypoglycemic, and gastroprotective properties [63]. Therefore, the wound healing property of the aloe vera plant has been widely studied and many procedures have been revealed to make use of this compound for wound healing and dressing purposes [64]. ...
There is a growing demand for biomaterials developing with novel properties for biomedical applications hence, hydrogels with 3D crosslinked polymeric structures obtained from natural polymers have been deeply inspected in this field. Pectin a unique biopolymer found in the cell walls of fruits and vegetables is extensively used in the pharmaceutical, food, and textile industries due to its ability to form a thick gel-like solution. Considering biocompatibility, biodegradability, easy gelling capability, and facile manipulation of pectin-based biomaterials; they have been thoroughly investigated for various potential biomedical applications including drug delivery, wound healing, tissue engineering, creation of implantable devices, and skin-care products.
... Therefore, Aloe vera gel is used in various commercial products to apply on wound, burn, and frost-bite treatment, diabetes treatment, and gastric ulcer treatment. In addition, many researches investigate Aloe vera gel which conjugates with synthetic and natural polymers has positive effects on mechanical, biocompatibility and degradation of resulting films (Darokar et al., 2003;Boudreau, Beland, 2006;Maenthaisong et al., 2007). ...
Currently silk fibroin is used more and more in the biomedical researches, including a potential research direction in creating wound dressing. Aloe vera gel has been used as a traditional herbal with many properties suitable for treatment of burns such as anti-inflammatory, anti-bacterial, anti-fungal, especially improvable wound healing. Therefore, the prepared fibroin/ Aloe vera gel film (FAV) was an ideal material for wound dressings. In this study, sericin is removed from the silk to obtain fibroin fiber. Aloe vera gel is purchased from Traditional Medicine Institute, Ho Chi Minh city, Viet Nam. Fibroin fiber and Aloe vera gel are dissolved by formic acid adding calcium chloride (CaCl2). Created FAV are then evaluated in some characteristics such as surface structure, tensile strength, absorbency, dehydration rate, biodegradation ability, preventing bacteria ability and cytotoxicity test. The results showed that FAV possessed good mechanical properties, suitable water vapor transmission rate, effective prevention of bacterial penetration and non-cytotoxic. This study is the first step to creating foundation and orientation for the development of commercial wound dressings.
... La evidencia científica de estudios en animales y en seres humanos ha incrementado la credibilidad de los beneficios para la salud debidos a la ingesta del jugo de Aloe vera (Pedroza, 2001). Las investi-gaciones sobre los efectos medicinales del Aloe vera L, refieren en que desde hace muchos años es utilizada en la elaboración de medicamentos destinados a tratar quemaduras (Campos, 1998;Maenthaisong et al., 2007), ulceras pépticas (Stevens, 2006), lesiones de la mucosa gástrica (Lujan et al., 2008), así como antiinflamatorio y de proliferación celular (Rodríguez et al., 2006;Khorasani et al., 2009). De igual manera se ha empleado en la fabricación de fármacos antimicóticos, antibacteriales y antivirales (Hamman, 2008;Tereza et al., 2008), basándose en investigaciones realizadas en modelos animales de laboratorio, para evaluar su efecto en el combate de enfermedades (Álvarez et al., 1996). ...
... This plant is well known in wound healing promotion; it has a miraculous healing potency and contains essential nutrients for cells survival. [22,23] The inner gel in Aloe Vera leave consists of 96% water and 75 other active components. Historically, many studies have demonstrated that Aloe Vera has superb activities, such as anti-inflammatory, antibacterial, antifungal, anticancer and even antioxidant activities. ...
Aim: Aim of the study is evaluate the efficacy of HBSS, Green tea extract and Aloe Vera gel as storage media in maintaining the viability of periodontal ligament cell. Material and Method: Fifty- five human teeth with closed apices and with apparently normal periodontium were extracted as atraumatically as possible for orthodontic reasons were collected for study. Teeth were randomly divided into positive control group, negative control group, three experimental group. Teeth in experimental groups were dried for 30 minutes (including time taken for curetting coronal PDL cells), followed by a 45-minute immersion in one of the three storage solution groups. The teeth in positive control group after extraction was immediately treated with collagenase. The teeth in negative control group were bench- dried for 8 hours, with no follow- up storage solution time, and then placed in the collagenase. Result: HBSS is the best medium for the maintaining the viability of the PDL Cells.But easier availability and cost effectiveness, GTE and Aloe Vera Gel can be advocated as a viable storage medium. Conclusion: It can be concluded that GTE and Aloe Vera Gel can be advocated as a viable storage medium.
... A Aloe vera é um membro entre as mais de 400 espécies pertencentes à família Liliaceae, frequentemente utilizado para fins terapêuticos. É uma planta tropical crescida facilmente em climas subtropicais e tropicais secos, incluindo o Brasil (Maenthaisong et al., 2007). A composição química difere a depender das condições ambientais entre as espécies de Liliaceae pois elas são bastante semelhantes entre si, podendo ocorrer em algumas, maior concentração de compostos do que em outras, a depender da qualidade do ambiente onde o vegetal se encontra (Souza et al., 2017). ...
Objetivo: Identificar as principais propriedades farmacológicas da Aloe vera. Metodologia: Trata-se de uma revisão integrativa realizada nas bases de dados eletrônicas LILACS, SciELO e PubMed, por meio dos seguintes descritores: “Aloe vera”, “Substâncias Isoladas” e “Atividades Biológicas”. Foram incluídos artigos completos, disponíveis em português e inglês, publicados entre janeiro de 2011 a dezembro de 2021. Resultados: A amostra final foi composta por 07 artigos, publicados no intervalo anual entre 2011 a 2020. Em relação à abordagem dos artigos encontrados, verifica-se que a maior parte utilizou o estudo experimental (n: 05), com nível de evidência moderado (III), seguido do ensaio clínico randomizado (n: 02), com nível de evidência forte (II). As principais propriedades farmacológicas identificadas da Aloe vera foram sua ação anti-inflamatória (redução de eritema, exsudato e dor), antimicrobiana, antioxidante, cicatrizante (redução do tempo para cicatrização de feridas agudas e crônicas) e hipoglicemiante (inibição de elevação da glicose pós-prandial). Conclusão: Numerosas atividades biológicas foram atribuídas a Aloe vera ao longo dos anos, especialmente por causa da combinação dos diversos compostos ativos existentes em sua composição. Verificou-se que esta planta medicinal possui diversos efeitos farmacológicos, como ação anti-inflamatória, antimicrobiana, antioxidante, cicatrizante e hipoglicemiante.
Background and Objectives: Good scar management in burn care is essential. Nevertheless, there are no consistent recommendations regarding moisturizers for scar management. Our aim was to investigate and compare the effects of commonly used products on normal skin and burn scars. Materials and Methods: A total of 30 skin-healthy (control group) and 12 patients with burn scars were included in this study. For an intraindividual comparison, each participant received creams consisting of dexpanthenol (P), aloe vera (A), and a natural plant oil (O) with instructions to apply them daily to a previously defined area for at least 28 days. Objective scar evaluation was performed with Visioscan®; Tewameter®; Cutometer®, and the Oxygen To See® device. Subjective evaluation was performed with an “application” questionnaire, the Patient and Observer Scar Assessment Scale (POSAS), and with the “best of three” questionnaire. Results: After (A) a high trend of amelioration of +30%, TEWL was detected on the scar area. Blood flow increased slightly on healthy skin areas after (A) application to +104%. The application of (A) on healthy skin demonstrated a positive effect on the parameters of scaliness (+22%, p < 0.001), softness (+14%, p = 0.046), roughness R1 (+16%, p < 0.001) and R2 (+17%, p = 0.000), volume (+22%, p < 0.001), and surface area (+7%, p < 0.001) within the control group. After (P), a significant improvement of the baseline firmness parameter of +14.7% was detected (p = 0.007). (P) also showed a beneficial effect on the parameters of R1 (+7%, p = 0.003), R2 (+6%, p = 0.001), and volume (+17%, p = 0.001). (O) lead to a statistically significant improvement of volume (+15%, p = 0.009). Overall, most study participants stated (A) to be the “best of three”. Conclusions: (A) performed statistically best, and is a well-tolerated moisturizing product. However, further quantitative studies are needed to provide statistically significant clarification for uniform recommendations for scar therapy.
This study aims to evaluate the wound healing activity of distilled water, metanol, n-hexane and ethyl acetate exracts of Centaurea pterocaula Trautv. on dorsal interscapular surface of rats which are wounded with 6 mm punch. The powdered leaves of Centaurea pterocaula Trautv. are extracted in distilled water, methanol, Nhexane and ethyl acetate and these extracts are prepared in the form of ointment mixed with petrolatum and the ointment form of extracts are pomaded to the wounds of rats topically. In the end of the measurement of wound area at 0, 2, 4, 6, 8, 10 and 12th days it is determined that the rats, N-hexane extract is implemented, have a significant difference from the other groups in terms of the contraction of wound area statistically and as a the result of histopathological research at 12th day it is founded that collagen synthesis, the component of ligament, has increased significantly on wound tissue. According to our study results; it can be said that the N-hexane extract of Centaurea pterocaula Trautv. which is used traditionally in the Eastern Anatolia of Turkey for wound healing has accelerating effect on wound healing and also it can be said that it has positive contribution to healing process. However, further studies are needed for enlightening the mechanism exactly. It is concluded that the wound healing effect of Centaurea pterocaula Trautv. is promising for “new drug development” studies.
Aloe vera (synonym Aloe barbadensis Mill) commonly known as Barbados or Curaçao Aloe, is a plant that has been used in traditional and folk medicine for hundreds of years to heal a wide range of illnesses. It is a shrubby or arborescent, perennial, succulent xerophytic, pea-green plant that is a member of the family Liliaceae or Asphodelaceae. Aloe vera is commonly known because of its wide range therapeutic benefits. It is the most frequent natural sources of health for people.The plant’s chemical composition reveals that there are several physiologically active compounds. Numerous biological traits of the Aloe species are influenced by the inner gel of the leaves. Most research has concentrated on the biological characteristics of various Aloe species, like the antibacterial and antimicrobial activities of the nonvolatile leaf gel components. Aloe species are found practically everywhere in the world and are particularly common in Eastern Europe and Africa. The physicochemical, and histological analyses of Aloe species are presented in this chapter.
Article Info ABSTRACT 10.30699/jambs.31.146.268 Background & Objective: A variety of synthetic and chemical drugs have been established for the treatment of candidiasis, but each has some limitations and its probable side effects. This study attempts to touch upon the antifungal activity of different concentrations of hydroalcoholic extracts of Aloe vera against Candida albicans in in vitro conditions. Materials & Methods: Hydroalcoholic extract from Aloe vera leaves was tested for anti-fungal activity via an in vitro study. Anti-fungal activity and minimum inhibitory concentration (MIC) were determined by the disk diffusion method. Aloe vera hydroalcoholic extracts (75%, 50%, 25%, and 12.5%) were used as test groups. The data were analyzed by ANOVA using SPSS 23 software. The level of statistical significance was set at p≤ 0.05. Results: The results revealed that Aloe vera contained substantial anti-fungal activity. There was a significant discrepancy in the mean diameter of the inhibition zone of C. albicans growth among different concentrations of Aloe vera (p-value=0.001). Also, there was a statistically significant difference between the average diameter of the inhibition zone of C. albicans growth at a concentration of 12.5% of Aloe vera extract compared to concentrations of 25%, 50%, and 75% Aloe vera, and concentration of 50% with 25% and 75% extracts. Aloe vera extract at 75% concentration effectively inhibited the growth of C. albicans compared with the positive control-nystatin. In this study, Aloe vera concentration of 20% was determined as the MIC for C. albicans. Conclusion: In adherence to the present results, it seems that Aloe vera extract, which is inexpensive and has no side effects, could be introduced as an alternative to nystatin.
The crosslinked sodium alginate/mucilage/Aloe vera/glycerin was optimized by different ratios of each factor to be an absorption wound dressing base for infected wound healing. Mucilage was extracted from seeds of Ocimum americanum. The Box-Behnken design (BBD) in response surface methodology (RSM) was used to construct an optimal wound dressing base with the target ranges of mechanical and physical properties of each formulation. The independent variables selected were sodium alginate (X1: 0.25-0.75 g), mucilage (X2: 0.00-0.30 g), Aloe vera (X3: 0.00-0.30 g), and glycerin (X4: 0.00-1.00 g). The dependent variables were tensile strength (Y1: low value), elongation at break (Y2: high value), Young's modulus (Y3: high value), swelling ratio (Y4: high value), erosion (Y5: low value), and moisture uptake (Y6: high value). The results showed that the wound dressing base with the most desirable response consists of sodium alginate (59.90 % w/w), mucilage (23.96 % w/w), and glycerin (16.14 % w/w) without Aloe vera gel powder (0.00 % w/w).
Prolonged inflammation and infection are the major factors that promote chronicity of the wound. Despite the substantial advancements in therapeutic modalities, the treatment of chronic wounds still represents a major clinical challenge. Conventional remedies are associated with several complications like drug resistance, systemic toxicity, and serious side effects that need to be addressed. This necessitates the development of safe and alternative pro-healing agents for efficient wound repair. In this scenario, the application of phytoconstituents has garnered much attention due to their safety profile and cost-effectiveness. They enhance the wound repair process by modulating various signaling pathways like TGF-β, NFκB, Nrf2, MAPK, etc, and promote cell proliferation, migration, differentiation, angiogenesis, and inhibit inflammation. The topical route of drug administration is the most preferable method of drug delivery for the effective management of chronic wounds. Currently, much emphasis has been given to the formulation of different phytoconstituents-based topical delivery systems like hydrogels, films, foam, sponges, fibers, nanoformulations, etc. These topical formulations improve the pharmacokinetic and physicochemical features of phytoconstituents. The main emphasis of the present review is to discuss the therapeutic potential, pharmacological importance, and current clinical status of various phytoconstituents-based topical formulations as well as their associated molecular mechanisms in chronic wound management.
An essential category of the biological resources of Africa are plants with nutritional and therapeutic properties and they are common all over Africa. Folk remedies are relied on by almost 80% of people in underdeveloped and developing nations because of their indigenous knowledge, availability, and cost-effectiveness. Aloe barbadensis Miller, generally known as Aloe vera, is one of more than 400 species of Aloe belonging to the Liliaceae family that originated in Africa, but is considered native to arid subtropical and tropical regions of the world. More than 200 distinct biologically active compounds have been found in the plant and most of them possess one biological activity or the other. Also, more than a hundred different nutrients and beneficial chemicals make up the leaf gel's interior composition. This chapter discusses the occurrence and botanical description, processing, chemistry, historical use, options for domestication, technologies for the production of high-value therapeutics potentials, medicinal uses, and safety, toxicity, and conservation strategies of the Aloe barbadensis.Keywords
Aloe barbadensis
Therapeutic potentialSafetyToxicityMedicinal usesChemistryCultivationConservation strategies
The active ingredients of Aloe vera have attracted attention for their potential use in nanotechnology-based medical applications and biomaterial production. It has many therapeutic applications in modern world. This study used Aloe vera extract in different concentrations to synthesize Aloe vera-incorporated hybrid nanoflowers (AV-Nfs). The most uniform morphology in the nanoflowers obtained was at a concentration of 2 mL. The AV-Nfs were well characterized by scanning electron microscopy, X-ray spectroscopy, Fourier transform infrared spectroscopy, and X-ray diffraction (XRD). The highest peroxidase-mimicking activity of the components was 1.488 EU/mg at 60°C and pH 6. The DPPH assay determined the antioxidant activity of the components and the MTT assay tested on CCD-1072Sk fibroblast cell line determined the effect of AV-Nfs on cell proliferation. Separate treatment of AV-Nfs with Cu3(PO4)2·3H2O significantly increased cell proliferation according to free Aloe vera and CuSO4. In vitro wound healing results showed that AV-Nfs could significantly close wounds compared to free Aloe vera. In this study, AV-Nfs showed antimicrobial activity against Staphylococcus epidermidis, Enterococcus faecalis, Escherichia coli and Klebsiella pneumoniae at minimum inhibitory concentration of 625 μg/mL, suggesting that AV-Nfs may be used in wound healing applications with enhanced biological properties. AV-Nfs showed no activity against the yeast Candida albicans.
The goal of this work is to encapsulate Eucalyptus staigeriana essential oil in biopolymer matrices, to optimize the biological effects and the antibacterial properties of this oil. In this study, Eucalyptus extract was encapsulated in Aloe Vera coated Dextran Sulfate/Chitosan nanoparticles to form a hydrogel with potent properties. In this study, Eucalyptus extract was loaded on to Aloe Vera coated Dextran Sulphate/Chitosan nanoparticles to obtain a nano-hydrogel with potent properties. The characterization of nanoparticles was evaluated using transmission and scanning electron microscopes, dynamic light scattering, Fourier transform infrared spectroscopy, differential scanning calorimetry and antibacterial activity. The Eucalyptus staigeriana release profile from the prepared nanoparticles was studied in vitro at a pH of 7.4. The results showed that this nano-carrier controls Eucalyptus release. Aloe Vera coated Dextran Sulfate/Chitosan nanoparticles encapsulated with Eucalyptus staigeriana inhibited the bacteria by 47.27%. These investigations concluded that Eucalyptus staigeriana loaded Aloe Vera coated Dextran Sulfate/Chitosan hydrogel could be used as a powerful dressing material to accelerate wound healing.
Burn injuries are a significant cause of pediatric morbidity and mortality worldwide. The overwhelming burden of these injuries is borne by children in low- and middle-income countries (LMICs). This chapter discusses a representative case and briefly details the epidemiology, classification, and management of burn injuries in LMICs.
In the current state of environmental awareness, new quality criteria stress not only the intrinsic usefulness and lifespan of the product, but also an environmental friendly manufacturing method. As a result, global interest is being generated in research on eco-friendly antimicrobial compounds based on natural materials such as A.vera for textile applications. This research presents a detailed evaluation of the activity of antimicrobial characteristics of aloe vera on cotton and silk fabric, as well as its physical and chemical effect, whiteness index, and fabric zone of inhibition. The mechanism of antibacterial activity of several kinds of active components identified in natural product extracts has been addressed. The key constraints and future prospects of A.vera for textile applications have also been thoroughly examined.
Current research across the globe still focuses strongly on naturally derived biomaterials in various fields, particularly wound care. There is a need for more effective therapies that will address the physiological deficiencies underlying chronic wound treatment. The use of moist bioactive scaffolds has significantly increased healing rates compared to local and traditional treatments. However, failure to heal or prolonging the wound healing process results in increased financial and social stress imposed on health institutions, caregivers, patients, and their families. The urgent need to identify practical, safe, and cost-effective wound healing scaffolding from nature-based biomaterials that can be introduced into clinical practice is unequivocal. Naturally derived products have long been used in wound healing; however, clinical trial evaluations of these therapies are still in their infancy. Additionally, further well-designed clinical trials are necessary to confirm the efficacy and safety of nature-based biomaterials in treating wounds. Thus, the focus of this review is to describe the current insight, the latest discoveries in selected nature-based wound healing implant products, the possible action mechanisms, and an approach to clinical studies. We explore several tested products undergoing clinical trials as a novel approach to counteract the debilitating effects of impaired wound healing.
Background:
Essential oils (EOs) have been considered as a potential alternative therapy for wound healing and scar reduction.
Objective:
To provide a comprehensive review examining the effects of EOs on wound healing and scars.
Data sources:
PubMed, Cochrane, Ovid and Embase computerized searches were performed through June 2020.
Review methods:
Two independent reviewers conducted data extraction reviewed by the senior author following the PRISMA protocol.
Results:
Three manuscripts examining three different EO-containing topical agents were analyzed. Outcomes include: healing rate, erythema, pain, pruritus, patient discomfort, physician satisfaction, percent wound reduction, wound/scar surface perimeter area, and qualitative dermatological evaluation. All articles concluded that the EO-containing topical agents resulted in either superior or non-inferior outcomes in comparison to controls. Hypericum-Calendula oil obtained lower wound surface perimeter area. Erythema (p=.001) was significantly decreased by the peppermint EO-containing topical agent preparation. Physicians also reported greater satisfaction (p<.001) in wound appearance with use of the peppermint EO-containing topical agent. CONCLUSION: A paucity of studies have examined EO use for wound healing and scar reduction. Treatment with EO-containing topical agents resulted in decreased erythema with increased physician satisfaction of wound appearance. Future studies should assess what level of purity is needed for improved results, and which EO, or combination of EOs is most beneficial.
Under normal circumstances, wound healing can be summarized as three processes. These include inflammation, proliferation, and remodeling. The vast majority of wounds heal rapidly; however, a large percentage of nonhealing wounds have still not been studied significantly. The factors affecting wound nonhealing are complex and diverse, and identifying an effective solution from nature becomes a key goal of research. This study aimed to highlight and review the mechanisms and targets of natural products (NPs) for treating nonhealing wounds. The results of relevant studies have shown that the effects of NPs are associated with PI3K-AKT, P38MAPK, fibroblast growth factor, MAPK, and ERK signaling pathways and involve tumor growth factor (TNF), vascular endothelial growth factor, TNF-α, interleukin-1β, and expression of other cytokines and proteins. The 25 NPs that contribute to wound healing were systematically summarized by an inductive collation of the six major classes of compounds, including saponins, polyphenols, flavonoids, anthraquinones, polysaccharides, and others, which will further direct the attention to the active components of NPs and provide research ideas for further development of new products for wound healing.
Aloe vera (Aloe barbadensis Miller) is widely spread around the world and it is used in the food and cosmetic industry and traditional medicine due to its high content in bioactive compounds. Thus, this article investigated the phenolic compounds of Romanian Aloe vera gel and its antioxidant capacity. The gel was extracted using 4 different solvents: methanol, ethanol, water, and acetone. Total phenolics were measured by the Folin-Ciocalteu method, total flavonoids by aluminium chloride reaction, and the antioxidant capacity by DPPH radical-scavenging activity. The profile of the phenolic compound was determined using Fourier transform infrared spectroscopy and Liquid Chromatography-Diode Array Detection–Electro-Spray Ionization Mass Spectrometry. The methanolic extract had a significantly higher antioxidant activity, followed by ethanolic, water, and acetone extracts. The methanolic extract had also the highest total polyphenol content, while ethanolic extract had the highest total flavonoid content. The extracts contained 14 compounds identified as 7 chromones (Aloesin, Neoaloesin, Aloinoside A, Aloinoside E, Aloe-emodin-glucoside, Isoaloeresin D, Methoxycoumaroyl-aloresin) 2 flavones (Luteolin-glucoside, Apigenin-glucoside), one hydroxycinnamic acid (Caffeic acid) and 4 to anthrones (Aloin A, Aloin B, Emodin, Aloe-emodin). The LC-MS results showed important quantities of Aloesin, Neoaloesin, Aloeresin E, and Aloe-emodin-glucoside while FTIR analysis showed the presence of polysaccharides, pectins, anthraquinones, and saponins.
Objective: Several studies have used aloe vera hydrogel to enhance various tissues regeneration to reduce scar formation in wounds. This study aimed to prepare a hydrogel specified for the oral cavity and observe scar formation and healing of free gingival graft after its application compared with the natural healing and scaring of the graft without any material.
Design: This study is a randomized controlled clinical trial that included 22 patients with a width of attached gingiva less than 2 mm. after preparing the aloe vera hydrogel and completing the laboratory stage, the hydrogel was randomly applied for 11 patients after the free gingival graft procedure while the other 11 patients did not use any material after the same surgery. Landry’s scale was used to assess the healing index, scarring was evaluated using Mucosal Scarring Index.
Results: The healing index was higher in the intervention group with a statistical difference P
Ethnopharmacological relevance
Aloe vera (L.) Burm. f. (Liliaceae family) is a well-known traditional medicinal plant, that has been used to treat a variety of illnesses, for decades ranging from cancer to skin disorders including wounds. It has been included in the traditional and herbal healthcare systems of many cultures around the world, as well as the pharmacopeia of different countries. Several in vitro and in vivo studies have also confirmed its potential antioxidant, anti-inflammatory, and wound-healing activities, etc. in the consistency of its historical and traditional uses. However, most studies to date are based on the A. vera gel and latex including its wound-healing effects. Very few studies have been focused on its flower, and rarely with its effects on cutaneous wound healing and its molecular mechanism.
Aim of the Study: To the best of our knowledge, this is the first study to report on the synergistic effect of the A. vera flower (AVF) and Aloe gel (PAG) on cutaneous wound-healing, as well as revealing its molecular mechanism targeting microfibril-associated glycoprotein 4 (MFAP4) and its associated signaling pathway.
Methods
To investigate the synergistic effect of A. vera flower and Aloe gel in cutaneous wound healing, cell viability, and cell migration, as well proliferation assay was performed. This was followed by quantitative real-time polymerase chain reaction and western blot analyses in wounded conditions to check the effects of this mixture on protein and mRNA levels in normal human dermal fibroblast (NHDF) cells. Moreover, small interfering RNA (siRNA) -mediated knockdown of MFAP4 in NHDF cells was performed followed by migration assay and cell cycle analysis, to confirm its role in cutaneous wound healing. Additionally, HaCaT cells were included in this study to evaluate its migratory and anti-inflammatory effects.
Results
Based on our obtained results, the PAG and AVF mixture synergistically induced the proliferation, migration, and especially ECM formation of NHDF cells by enhancing the expression of MFAP4. Other extracellular components associated with MFAP4 signaling pathway, such as fibrillin, collagen, elastin, TGF β, and α-SMA, also increased at both the protein and mRNA levels. Subsequently, this mixture initiated the phosphorylation of the extracellular signal-regulated kinase(ERK) and AKT signaling pathways, and the S-phase of the cell cycle was also slightly modified. Also, the mixture induced the migration of HaCaT cells along with the suppression of inflammatory cytokines. Moreover, the siRNA-mediated knockdown highlighted the crucial role of MFAP4 in cutaneous wound healing in NHDF cells.
Conclusion
This study showed that the mixture of PAG and AVF has significant wound healing effects targeting MFAP4 and its associated signaling pathway. Additionally, MFAP4 was recognized as a new potential biomarker of wound healing, which can be confirmed by further in vivo studies.
In a study of twenty-seven patients with partial thickness burn wound, they were treated with aloe vera gel compared with vaseline gauze. It revealed the aloe vera gel treated lesion healed faster than the vaseline gauze area. The average time of healing in the aloe gel area was 11.89 days and 18.19 days for the vaseline gauze treated wound. Statistical analysis by using t-test and the value of P < 0.002 was statistically significant. In histologic study, it showed early epithelialization in the treated aloe vera gel area. Only some minor adverse effects, such as discomfort and pain were encountered in the 27 cases. This study showed the effectiveness of aloe vera gel on a partial thickness burn wound, and it might be beneficial to do further trials on burn wounds.
It has been suggested that the quality of clinical trials should be assessed by blinded raters to limit the risk of introducing bias into meta-analyses and systematic reviews, and into the peer-review process. There is very little evidence in the literature to substantiate this. This study describes the development of an instrument to assess the quality of reports of randomized clinical trials (RCTs) in pain research and its use to determine the effect of rater blinding on the assessments of quality. A multidisciplinary panel of six judges produced an initial version of the instrument. Fourteen raters from three different backgrounds assessed the quality of 36 research reports in pain research, selected from three different samples. Seven were allocated randomly to perform the assessments under blind conditions. The final version of the instrument included three items. These items were scored consistently by all the raters regardless of background and could discriminate between reports from the different samples. Blind assessments produced significantly lower and more consistent scores than open assessments. The implications of this finding for systematic reviews, meta-analytic research and the peer-review process are discussed.
With the development of evidence-based dentistry it is important to consider how accurate and representative our published pool of evidence is. In this article we will describe publication bias and discuss the causes and potential effects it may have upon the pool of scientific evidence available in dentistry.
Publication bias arises whenever the probability that a study is published depends on the statistical significance of its results. This bias, often called the file-drawer effect since the unpublished results are imagined to be tucked away in researchers' file cabinets, is potentially a severe impediment to combining the statistical results of studies collected from the literature. With almost any reasonable quantitative model for publication bias, only a small number of studies lost in the file-drawer will produce a significant bias. This result contradicts the well known Fail Safe File Drawer (FSFD) method for setting limits on the potential harm of publication bias, widely used in social, medical and psychic research. This method incorrectly treats the file drawer as unbiased, and almost always miss-estimates the seriousness of publication bias. A large body of not only psychic research, but medical and social science studies, has mistakenly relied on this method to validate claimed discoveries. Statistical combination can be trusted only if it is known with certainty that all studies that have been carried out are included. Such certainty is virtually impossible to achieve in literature surveys.
Aloe vera has been recognized as a valuable medicinal plant for the treatment of burns. Extensive studies have described its antiinflammatory, wound healing and related activities, but the instability of aloe gel confuses pharmacological data, leads to inconsistency in treatments and inconvenience in daily preparation. These obstacles prompted us to develop a stable aloe preparation, aloe cream, that we tested on artificial thermal burns in mice. Aloe cream when applied immediately to first degree burns delayed progressive damage and accelerated the healing rate more effectively than fresh aloe gel. Both aloe cream and fresh aloe gel prevented further skin damage and casting of dead epidermis was less than in control. For second degree burns the healing rate was enhanced by aloe cream and fresh aloe gel: less inflammation was observed in areas treated with either of these than in untreated areas or those treated with the cream base. For third degree burns the efficacy of aloe cream and fresh aloe gel could not be evaluated statistically because of infection. It was observed that aloe cream enhanced epithelialization but failed to show antiinflammatory activity. No differences in epithelialization and inflammation were observed among mice treated with fresh aloe gel, cream base or control. All these findings confirm that Aloe vera gel is effective for burn treatment if it is well preserved.
The polysaccharides present in Aloe vera gel are presumed to play a key role in the clinical activity of the gel. While clinical studies generally confirm the contribution of the gel to a reduction in inflammation and an acceleration of healing, in some cases the expected therapeutic activity is not observed. This variability could perhaps be attributed to differences in the source of the gel, horticultural conditions and/or post-harvest treatments. Accordingly, polysaccharide content and composition and gel consistency were studied as a function of growth conditions in gels obtained from shrubs of Aloe barbadensis Miller grown in the Negev region of Israel. Autodegradation of the polysaccharides in the freshly produced gel was also characterized, and a method was developed for retarding this process. The polysaccharides were found to consist of glucomannans. Polysaccharides constituted 0.2–0.3% of the fresh gel and 0.8–1.2% of the dry matter content. Irrigation had a greater influence on gel composition than leaf age or season. The fresh gel showed pseudoplastic behaviour, which became Newtonian as a result of post-production autodegradation. The polysaccharides remaining after degradation were mainly mannans. Addition of a natural polysaccharide extracted from a species of red microalgae produced a soft pseudoplastic gel with synergistic rheological properties. The addition of the algal polysaccharide preserved the physical properties of the natural aloe polysaccharides. Chemical means were used to retard microbial degradation.
The positive influence of Aloe vera, a tropical cactus, on the healing of full-thickness wounds in diabetic rats is reported. Full-thickness excision/incision wounds were created on the back of rats, and treated either by topical application on the wound surface or by oral administration of the Aloe vera gel to the rat. Wound granulation tissues were removed on various days and the collagen, hexosamine, total protein and DNA contents were determined, in addition to the rates of wound contraction and period of epithelialization. Measurements of tensile strength were made on treated/untreated incision wounds. The results indicated that Aloe vera treatment of wounds in diabetic rats may enhance the process of wound healing by influencing phases such as inflammation, fibroplasia, collagen synthesis and maturation, and wound contraction. These effects may be due to the reported hypoglycemic effects of the aloe gel.
Administration of air under the skin produced a pouch wall that closely resembled a synovium in that the inner lining was made up of macrophages and fibroblasts. Administration of 1% carrageenan directly into the 7-day-old air pouch produced an inflammation characterized by an increased number of mast cells in pouch fluid as well as an increase in wall vascularity. A punch biopsy weight of the pouch wall did not reveal an increase in 1% carrageenan-treated animals. However, a 10% Aloe vera treatment of carrageenan-inflamed synovial pouches reduced the vascularity 50% and the number of mast cells in synovial fluid 48%. The pouch wall punch biopsy weight was increased by A. vera, which was verified by histologic examination of the inner synovial lining. Aloe vera stimulated the synovial-like membrane, as evidenced by an increased number of fibroblasts, suggesting that A. vera stimulated fibroblasts for growth and repair of the synovial model. The synovial air pouch can be used to study simultaneously the acute anti-inflammatory and fibroblast stimulating activities of A. vera.
Three women and one man aged forty-one to sixty-five years experienced a severe burning sensation following the application of aloe vera or vitamin E preparations to a skin area that had been subjected to a chemical peel or dermabrasion. Subsequently, a severe dermatitis occurred that required hospitalization of one patient and intravenous administration of steroids. The dermatitis abated very slowly in all patients: full recovery took three months or more. One patient resumed the use of vitamin E creams two years after the episode of dermatitis and experienced no adverse effect. Patients undergoing dermabrasion or chemical peel procedures should be cautioned specifically against the use of aloe vera or vitamin E topically in the first weeks after surgery.
An experimental study was designed using Hartley guinea pigs, who received full-thickness burns covering 3 percent of their body surface area by direct contact with a hot plate. A total of 40 animals were equally divided among four modalities of closed burn wound management as follows: group I: silver sulfadiazine (Silvadine); group II: aloe vera gel extract (Carrington Dermal Wound Gel); group III: salicylic acid cream (aspirin); and group IV: plain gauze occlusive dressing only. The dressings were changed daily, and the size and appearance of each burn wound were recorded until complete healing. On the sixth postburn day, quantitative burn wound cultures were made. The average time to complete healing in the control group was 50 days, and the only significant difference was found in the aloe vera-treated animals, which healed on an average of 30 days (p less than 0.02). Wound bacterial counts were effectively decreased by silver sulfadiazine (p = 0.015) and by aloe vera extract (p = 0.015). From our data it appears that aloe gel extracts permit a faster healing of burn wounds.
The mucilaginous gel from the parenchymatous cells in the leaf pulp of Aloe vera has been used since early times for a host of curative purposes. This gel should be distinguished clearly from the bitter yellow exudate originating from the bundle sheath cells, which is used for its purgative effects. Aloe vera gel has come to play a prominent role as a contemporary folk remedy, and numerous optimistic, and in some cases extravagant, claims have been made for its medicinal properties. Modern clinical use of the gel began in the 1930s, with reports of successful treatment of X-ray and radium burns, which led to further experimental studies using laboratory animals in the following decades. The reports of these experiments and the numerous favourable case histories did not give conclusive evidence, since although positive results were usually described, much of the work suffered from poor experimental design and insufficiently large test samples. In addition some conflicting or inconsistent results were obtained. With the recent resurgence of interest in Aloe vera gel, however, new experimental work has indicated the possibility of distinct physiological effects. Chemical analysis has shown the gel to contain various carbohydrate polymers, notably either glucomannans or pectic acid, along with a range of other organic and inorganic components. Although many physiological properties of the gel have been described, there is no certain correlation between these and the identified gel components.
This paper examines eight published reviews each reporting results from several related trials. Each review pools the results from the relevant trials in order to evaluate the efficacy of a certain treatment for a specified medical condition. These reviews lack consistent assessment of homogeneity of treatment effect before pooling. We discuss a random effects approach to combining evidence from a series of experiments comparing two treatments. This approach incorporates the heterogeneity of effects in the analysis of the overall treatment efficacy. The model can be extended to include relevant covariates which would reduce the heterogeneity and allow for more specific therapeutic recommendations. We suggest a simple noniterative procedure for characterizing the distribution of treatment effects in a series of studies.
Recent evidence from in vitro and in vivo experiments suggests that topical antimicrobials may be toxic to fibroblasts and keratinocytes and retard wound healing. The purpose of this study was to determine the effects of Aloe, a potential wound-healing agent, on wound contraction in excisional wounds treated with topical antimicrobials. Sprague-Dawley rats were prepared with four 1.5 cm2 dorsal defects through the skin and panniculus. The animals were divided into five groups (n = 10 per group): (1) Aloe, (2) NaOCl solution (0.025%), (3) mafenide acetate, (4) mafenide acetate + Aloe, and (5) control. Wounds were treated topically for 14 days 3 times a day. Serial standard photographs and serial wound planimetry were performed weekly. Following healing, the breaking strength of each resultant scar was determined using an Instron tensiometer. Kruskal-Wallis, ANOVA, and multiple comparison methods were used for data analysis. Aloe and NaOCl solution significantly accelerated wound contraction (p < 0.05). In the mafenide acetate + Aloe group, contraction was similar to the control, whereas the mafenide acetate alone retarded wound healing. The addition of Aloe in combination and alone in wounds increased the breaking energy when compared to controls (p < 0.05). Aloe appears to expedite wound contraction and neutralize the wound retardant effect seen with the topical mafenide acetate alone. This effect appears to be due to an increased collagen activity, which is enhanced by a lectin, consequently improving the collagen matrix and enhancing the breaking strength.
Wound healing is a fundamental response to tissue injury that results in restoration of tissue integrity. This end is achieved mainly by the synthesis of the connective tissue matrix. Collagen is the major protein of the extracellular matrix, and is the component which ultimately contributes to wound strength. In this work, we report the influence of Aloe vera on the collagen content and its characteristics in a healing wound. It was observed that Aloe vera increased the collagen content of the granulation tissue as well as its degree of crosslinking as seen by increased aldehyde content and decreased acid solubility. The type I/type III collagen ratio of treated groups were lower than that of the untreated controls, indicating enhanced levels of type III collagen. Wounds were treated either by topical application or oral administration of Aloe vera to rats and both treatments were found to result in similar effects.
Research since the 1986 review has largely upheld the therapeutic claims made in the earlier papers and indeed extended them into other areas. Treatment of inflammation is still the key effect for most types of healing but it is now realized that this is a complex process and that many of its constituent processes may be addressed in different ways by different gel components. A common theme running though much recent research is the immunomodulatory properties of the gel polysaccharides, especially the acetylated mannans from Aloe vera, which are now a proprietary substance covered by many patents. There have also been, however, persistent reports of active glycoprotein fractions from both Aloe vera and Aloe arborescens. There are also cautionary investigations warning of possible allergic effects on some patients. Reports also describe antidiabetic, anticancer and antibiotic activities, so we may expect to see a widening use of aloe gel. Several reputable suppliers produce a stabilized aloe gel for use as itself or in formulations and there may be moves towards isolating and eventually providing verified active ingredients in dosable quantities
The use of aloe vera is being promoted for a large variety of conditions. Often general practitioners seem to know less than their patients about its alleged benefits.
To define the clinical effectiveness of aloe vera, a popular herbal remedy in the United Kingdom.
Four independent literature searches were conducted in MEDLINE, EMBASE, Biosis, and the Cochrane Library. Only controlled clinical trials (on any indication) were included. There were no restrictions on the language of publication. All trials were read by both authors and data were extracted in a standardized, pre-defined manner.
Ten studies were located. They suggest that oral administration of aloe vera might be a useful adjunct for lowering blood glucose in diabetic patients as well as for reducing blood lipid levels in patients with hyperlipidaemia. Topical application of aloe vera is not an effective preventative for radiation-induced injuries. It might be effective for genital herpes and psoriasis. Whether it promotes wound healing is unclear. There are major caveats associated with all of these statements.
Even though there are some promising results, clinical effectiveness of oral or topical aloe vera is not sufficiently defined at present.
Aloe vera has been used as a family medicine for promoting wound healing, but it is not known which component of the plant is effective for this purpose.
To isolate and characterize the component effective in wound healing.
Chromatography, electrophoresis and spectroscopic methods were used. The cell-proliferation activity of each component isolated was measured by a [3H]thymidine uptake assay. The cell-proliferation activity of the effective component was tested on a three-dimensional raft culture (cell culture technique by which artificial epidermis is made from keratinocytes). The effect of the active component on cell migration and wound healing was observed on a monolayer of human keratinocytes and in hairless mice.
A glycoprotein fraction was isolated and named G1G1M1DI2. It showed a single band on sodium dodecyl sulphate-polyacrylamide gel electrophoresis, with an apparent molecular weight of about 5.5 kDa. It exhibited significant [3H]thymidine uptake in squamous cell carcinoma cells. The effect of G1G1M1DI2 on cell migration was confirmed by accelerated wound healing on a monolayer of human keratinocytes. When this fraction was tested on a raft culture, it stimulated the formation of epidermal tissue. Furthermore, proliferation markers (epidermal growth factor receptor, fibronectin receptor, fibronectin, keratin 5/14 and keratin 1/10) were markedly expressed at the immunohistochemical level. The glycoprotein fraction enhanced wound healing in hairless mice by day 8 after injury, with significant cell proliferation.
It is considered that this glycoprotein fraction is involved in the wound-healing effect of aloe vera via cell proliferation and migration.
WOC nurses may be asked to manage small burn wounds or to follow up with patients who have residual wound care issues after recovering from a major burn injury. Aspects of care include identifying patients who warrant a higher level of burn care expertise, managing small wounds, recognizing the common complications of burns, and determining the needs of patients undergoing burn rehabilitation. Persons managing burn wounds will incorporate a variety of techniques to facilitate wound cleansing and dressing, pain management, psychological support, and minimization of complications. In addition, depending on the setting, extent, and nature of the wounds, the patient's abilities and rehabilitation requirements will need to be determined. The patient and his or her family need to be educated about the normal changes that follow a burn injury and how to manage these issues.
Freeze-dried juice obtained from Aloe vera and heated for 15 minutes at 80° inhibited several test microorganisms.
Aloe vera: It's influence on the physiology of wound healing and inflammation
- Bradshaw
Bradshaw TW. Aloe vera: It's influence on the physiology of wound healing and inflammation. J Br Podiatr Med 1996;51(2):25–9.
Characterization of aloe vera gel before and after autodegradation, and stabilization of the natural fresh gel The Aloe vera phenomenon: a review of the properties and modern uses of the leaf parenchyma gel
- A Yaron
- D Grindlay
- Reynolds
Yaron A. Characterization of aloe vera gel before and after autodegradation, and stabilization of the natural fresh gel. Phytother Res 1993;7:S11–3. [30] Grindlay D, Reynolds T. The Aloe vera phenomenon: a review of the properties and modern uses of the leaf parenchyma gel. J Ethnopharmacol 1986;16:117–51.
People’s Liberation Army medicine information
- Chen Jh Sun
- Xg
- Rt Jin
- Li
- Bian
Sun JH, Chen XG, Jin RT, Li TN, Bian YX. People’s Liberation Army medicine information. Med J Chin Army 1994;8(4):191–2.
Characterization of aloe vera gel before and after autodegradation, and stabilization of the natural fresh gel 717 r[30] Grindlay D, Reynolds T. The Aloe vera phenomenon: a review of the properties and modern uses of the leaf parenchyma gel
- A Yaron
Yaron A. Characterization of aloe vera gel before and after autodegradation, and stabilization of the natural fresh gel. Phytother Res 1993;7:S11–3. burns 33 (2007) 713–718 717 r[30] Grindlay D, Reynolds T. The Aloe vera phenomenon: a review of the properties and modern uses of the leaf parenchyma gel. J Ethnopharmacol 1986;16:117–51.
People's Liberation Army medicine information
- Sun