Antioxidant Therapies for Wound Healing: A Clinical Guide to Currently Commercially Available Products

Abstract

Many facets of wound healing under redox control require a delicate balance between oxidative stress and antioxidants. While the normal physiology of wound healing depends on low levels of reactive oxygen species and oxidative stress, an overexposure to oxidative stress leads to impaired wound healing. Antioxidants are postulated to help control wound oxidative stress and thereby accelerate wound healing. Many antioxidants are available over the counter or by prescription, but only one, Medihoney®, has been specifically FDA approved for wound healing. Here we review the existing evidence for the use of antioxidants for wound healing, with a review of the pertinent animal and clinical studies. Natural products and naturally derived antioxidants are becoming more popular, and we specifically review the evidence for the use of naturally derived antioxidants in wound healing. Antioxidant therapy for wound healing is promising, but only few animal studies and even fewer clinical studies are available. Because only few products have undergone FDA approval, the consumer is advised to scrutinize them for purity and contaminants prior to use, and this may require direct contact with the companies that sell them. As a field of science, the use of antioxidants for wound healing is in its infancy, and future studies will better elucidate the role of antioxidants in wound healing.

Antioxidant, antimicrobial and wound healing properties ofStruthanthus vulgaris

“…Leaf extract of S. vulgaris exhibited an expressive amount of phenolic compounds and a moderate concentration of total flavonoids. Phytochemical constituents of a plant are often correlated to and determine the physiological action on the human body, and phenolic compounds are well-known molecules that have many biological properties, including antioxidant activity, that play an important role in wound healing by preventing and protecting oxidative damage from free radicals (Agyare et al, 2013;Fitzmaurice et al, 2011;Süntar et al, 2012). Using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, which is a widely used technique for measuring the antioxidant activity of plant extracts due to its low cost and accuracy, and the fact that it is easy to perform (Alam et al, 2013), the leaf and branch extracts showed strong antioxidant activity, confirming their antiradical properties.…”

“…Neutrophils are considered the first type of cells to be recruited into the site of injury, and have an important role in antimicrobial defense and the debridement of devitalized tissue by the production of proteolytic enzymes and reactive oxygen species (ROS) (Fitzmaurice et al, 2011). ROS is produced in high amounts at the wound site, as a defense mechanism against invading bacteria (Süntar et al, 2012).…”

Anti-inflammatory and wound healing potential of cashew apple juice (Anacardium occidentale L.) in mice

“…Furthermore, to maintain a controlled ROS tissue concentration, an intricate cellular signalization is required to avoid oxidative stress and further damage. 47,48 Furthermore, the nutritional supplementation with UNCAJ led to a better antioxidant balance favoring the healing process without interfering in the signalization process exerted by ROS. 48 Even if all tested groups were re-epithelialized within 14 days after the surgery, it should be underlined that UNCAJ was more sensitive to eosin stain, which indicates a better reorganization of collagen fibers, similar to REF (Figure 2).…”

“…47,48 Furthermore, the nutritional supplementation with UNCAJ led to a better antioxidant balance favoring the healing process without interfering in the signalization process exerted by ROS. 48 Even if all tested groups were re-epithelialized within 14 days after the surgery, it should be underlined that UNCAJ was more sensitive to eosin stain, which indicates a better reorganization of collagen fibers, similar to REF (Figure 2). Moreover, it must be emphasized that already after seven days, only UNCAJ and REF groups presented re-epithelialization, and no edema was verified.…”

Determination of antioxidants in two medicinally important plants, Haloxylon griffithii and Convolvulus leioclaycinus, of Balochistan

“…As a result, carcinogenesis, cardiovascular and inflammatory ailments may be developed [6]. Antioxidants are the bits which can scavenge such oxidants and stop tissue impairment [7]. They also diminish oxidative injuries to biomolecules by moderating the influence of active oxidants [8].…”