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Natural remedies for diabetic leg ulcer, open wounds

By Chukwuma Muanya
22 November 2018   |   2:46 am
More Nigerians are developing diabetes and its complications including leg ulcers. Foot ulcers are also common in sickle cell anaemia patients.


More Nigerians are developing diabetes and its complications including leg ulcers. Foot ulcers are also common in sickle cell anaemia patients.

Unfortunately, some of the patients blame the recalcitrant wounds on spiritual attack and poisoning from the village. Some at the first instance visit spiritual homes for solutions. They only resort to the hospital when it is already late and the option left for them is limb amputation.

The situation is made worse by the growing resistance of disease-causing microorganisms to available antibiotics. Consequently, some open wounds especially in diabetic and sickle cell patients have become untreatable.However, scientists have identified natural remedies for diabetic leg ulcers and open wounds. In fact most of the remedies are also anti-diabetic- the regulate blood glucose levels- and effective against antibiotic resistant microorganisms.

Successful repair of diabetic foot ulcer with honey-based treatment
Researchers have demonstrated how honey dressing with and without olive oil could successfully prevent the risk of amputation in case of diabetic foot ulcers.The study titled “Successful Repair of Diabetic Foot Ulcer with Honey-Based Treatment: A Case Report” was published in Iran Red Crescent Medical Journal.

The researchers from the Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran investigated the effectiveness of honey dressing in the presence or absence of olive oil in diabetic foot ulcer.

The study attempted to report a 70-year-old female with the history of diabetes undergoing high doses of oral anti-diabetes drugs (OADs). Following a car accident, she developed a neuropathic ulcer categorized as Wagner grade-II. The case was admitted in Imam Reza General hospital, Mashhad, Iran in August 2014.

A combined regimen of cephalexin, cefixime and anti- inflammatory drugs was started after hospitalization. Since granulation formation and tissue repair did not occur, honey dressing with and without olive oil was used to repair the ulcer. The whole treatment period lasted a month.

Leg ulcers heal faster with maggot therapy
Wound debridement is significantly faster with maggot therapy during the first week of treatment compared with conventional debridement, study data published online first in the Archives of Dermatology indicate.On day eight of treatment slough was 54.5 per cent in patients who received maggot debridement therapy (MDT) compared with 66.5 per cent (P=0.04) of wound area in a control group that received conventional treatment, Kristina Opletalová, MD, from the Centre Hospitalier Universitaire de Caen in France, and colleagues found.

However, at day 15, the difference in the mean percentage of slough in the MDT and control groups was not significant. Opletalová and colleagues compared the efficacy of bagged larvae and conventional treatment on wound debridement in 119 patients who had a non-healing, 40 cm² or smaller sloughy wounds, less than 2 cm deep and an ankle brachial index of 0.8 or higher. Patients were randomly assigned to receive either MDT or conventional treatment during a two-week hospital stay.

Patients in the MDT group received twice weekly therapy with a bag containing 80 sterile Lucilia sericata maggots that accessed the wound surface through a polyvinyl alcohol membrane. Control patients were administered surgical debridement with topical anesthesia, three-times a week. All patients were blind-folded during treatment and were unaware of differences in treatment schedules. Conventional dressings were applied at discharge, and follow-up was conducted at day 30.

At day 15, the wound surface area had increased by 14.6 per cent in MDT patients and had decreased by 8.2% among patients treated with surgical debridement (P=0.02), but healing rates were no longer significantly different at day 30.“Although MDT shows no significant benefit at day 15 compared with conventional treatment, debridement by MDT is significantly faster and occurs during the first week of treatment. Because there is no benefit in continuing the treatment after one week, another type of dressing should be used after two or three applications of MDT,” the researchers wrote.

A similar number of patients reported a “crawling sensation” in both groups; however, control treatment took significantly longer to perform at days one, eight, and 15, with topical anesthesia being applied 30 minutes before debridement (40.1 minutes vs. 10.1 minutes for maggot therapy, P<0.001). Surgical debridement also took longer even without the time for anesthesia (12.6 minutes vs 10.1 minutes, P=0.03).“Contrary to surgical debridement, [MDT] is easy, safe, painless and well accepted by the patient,” the researchers wrote. Prosopis africana stem bark for wound care
Researchers have demonstrated the effects of the methanol extract of the stem bark of Prosopis africana on bleeding/clotting and coagulation time, excision and dead space wounds were studied in rats. Also, the extract was subjected to antibacterial, and acute toxicity and lethality (LD50) tests. The extract significantly (P<0.05) reduced bleeding/clotting and coagulation time in rats. It also reduced epithelialization period of excision wounds in rats and inhibited the growth of laboratory strains of Staphylococcus aureus, Bacillus subtilis, Salmonella typhi, Pseudomonas aeruginosa and Klebsiella pneumoniae to varying extents. Acute toxicity and lethality (LD50) test on the extract established an LD50 of 774 mg/kg (i.p) in mice while phytochemical analysis gave positive reactions for alkaloids, saponins, tannins, flavonoids, steroids, terpenoids and carbohydrates. The results of this study demonstrate the beneficial effects of the stem bark of P. africana in wound care. The study was published in Indian Journal of Pharmaceutical Science.Prosopis africana (Fabaceae) is one of the plants used to stimulate wound healing in traditional medicine of south-eastern Nigeria. It is a tree with a very hard wood and easily distinguishable by its dark rough bark, pale drooping foliage with small pointed leaflets and sausage-shaped fruit. In Nigeria, P. africana is variously called Okpei (Igbo), Ayan (Yoruba), Okpeghe (Idoma and Tiv), and Kiriya or Kiriaya (Hausa). In traditional medicine practice, juice expressed from the stem bark is applied on open wounds as an astringent and to cleanse the wound surface. The bark is also crushed to a pulp and placed on the wound surface as a dressing. Healing wounds, others with local spice
Besides its popular use in treating diabetes, hypertension, epilepsy and convulsion, a local spice, Tetrapleura tetraptera could be effective used in healing wounds. Tetrepleura tetraptera belongs to the Mimosaceae/Fabacae family. It is locally known as aridan among the Yoruba, osakirisa or oshosho among the Igbo, dawo among the Hausa, all in Nigeria, and is also referred to as prekese among the Twi people of Ghana.

It is generally found in the lowland forest of tropical Africa. The fruit consist of a fleshy pulp with small, brownish-black seeds. The dry fruit has a pleasant aroma. It is therefore, used as a popular seasoning spice in Southern and Eastern Nigeria. The fruit is used to prepare soup for mothers from the first day of birth to prevent post partum contraction. Its fruits are used for the management of convulsions, leprosy, inflammation, rheumatism, flatulence, jaundice and fevers.

The anticonvulsant activity of the volatile oil from fresh fruits of T. tetraptera in mice has been reported. Its leaves are essential for the treatment of epilepsy and present strong molluscicidal activity. The aqueous fruit extract has also been shown to possess hypoglycaemic (blood glucose-reducing) properties. The root extract is also be used for the treatment of gastrointestinal related clinical problems.

But a study published in International Research Journal of Plant Science has shown that extracts of Tetrapleura tetraptera could be effectively used to heal wounds.The study is titled “Effect of aqueous extract of Tetrapleura tetraptera on excision wounds in albino rats.”The researchers from the Faculty of Pharmacy, University of Uyo, Akwa Ibom State, wrote: “In this study, Tetrapleura tetraptera was ascertained of its effect on wound healing. The Lethal dose (LD 50) of Tetrapleura tetraptera was determined and the research on its wound healing effect was carried out. The standard method of Nofal was adopted for the determination of the (LD50).

“Wound healing effect was done by excising wounds on anaesthesized rats and then the percentage wound closure (epithelialization) was determined from the treatment with different concentrations of the extract, negative control as well as the positive control. The (LD50) of Tetrapleura tetraptera was 10,000mg/kg body weight. The least concentration (200mg/ml) gave hundred percent (100 per cent) epithelialization at the end of the experiment; 2000mg/ml concentration of the extract delayed the wound healing effect of the plant.

“Conclusively, Tetrapleura tetraptera at 200mg/ml has a potent value of wound healing effect while 2000mg/ml of Tetrapleura tetraptera is not efficacious in wound healing. Thus, Tetrapleura tetraptera could be administered at 200mg/ml for the treatment of wounds.”

According to a study published in the Journal of Ethnopharmacology, the fruit of Tetrapleura tetraptera (Taub) [Fabaceae] is frequently used in Tropical African traditional medicine for the management and/or control of an array of human ailments, including arthritis and other inflammatory conditions, asthma, diabetes mellitus, hypertension, epilepsy, schistosomiasis, and so on.

African cherry provides novel cure for drug-resistant infections
New studies have shown that extracts of the leaves and stem bark of African cherry could be used effectively to treat drug-resistant infections; and may hold the key to new and effective alternative antimalarial medicine.A new study has established the possibility of developing antimicrobial agents of natural origin to manage possible infection from vancomycin-resistant Staphylococcus aureus (VRSA) that are now developing multi-resistance against many antibiotics.

The researchers concluded: “The bactericidal activities exhibited by C. albidium extract against VRSA used in this study revealed a significant therapeutic potential of this plant and supported its usefulness in folklore remedies for the management of infections caused by pathogens. The ability of the plant extract fractions obtained from C. albidium to kill VRSA in this study at low concentration and minimal contact time has established the potential of the plant as a template for future drugs that could be formulated to combat infections caused by VRSA; such drug would be useful in combating the menace of VRSAs in human and animal health.”

The study titled “Biocidal effects of stem bark extract of Chrysophyllum albidium G. Don on vancomycin-resistant Staphylococcus aureus” was published recently in the journal BMC Complementary and Alternative Medicine.

Local plant provides wound-healing compounds
Synthetic painkillers have been associated with unpleasant side effects such as organ failure. But the discovery in large quantities of molecules identical to popular synthetic painkiller, Tramadol, may provide the elusive ‘safe’ treatment for headaches, joints and waist pains and heal ‘stubborn’ ulcers and wounds.

Commonly called African peach or African pincushion tree, Nauclea latifolia belongs to the Rubiaceae family. In Nigeria, it is called Ebeyesi in Yoruba, Ubuluinu in Igbo and Tafashiya or Marga in Hausa. A recent study published in International Journal of Pharmaceutical Biomedical Science found that crude extracts of Nauclea latifolia showed significant wound healing activity when topically administered.

The researchers from the Faculties of Pharmacy, Universities of Uyo and Benin, concluded: “The methanol crude extract and the ethylacetate fraction demonstrated significant increase in wound closure. Any of the phytochemical constituents present in Nauclea latifolia may be responsible for the wound-healing activity.

“Studies with other plants have shown that phytochemical constituents like tannins and flavonoids are known to promote wound healing process mainly due to their astringent and antimicrobial properties, which appears to be responsible for wound contraction and increased rate of epithelisation.“The methanol crude extract and the ethylacetate fraction showed significant wound healing activity when topically administered on rabbits.

“The results offer pharmacological reason for the traditional use of the powdered stem bark of Nauclea latifolia for healing wounds. Further studies are therefore needed to better assess the potential value of Nauclea latifolia extracts as wound healing agents.”

Native pear exudates offer protection against skin problems
Scientific evaluation of the essential oil of native pear shows it has antimicrobial and antioxidant properties. Commonly called African pear, native pear or bush butter, Dacryodes edulis belongs to the plant family Burseraceae. It called safoutier in French. In Nigeria, it is ibe in Kalabari; boshu in Bokyi; orunmwun in Edo (indicating something edible); ube in Ibo; orumu in Urhobo; and elemi in Yoruba.

Resins or exudates from some species are used in African medicine. The stem bark yields a resin or exudates, which is also primitive oil. The resin is reported to be medicinal and is applied to cure skin diseases such as ringworms, craw-craw and wounds. They are also used to treat parasitic organism like ticks and jiggers.

Previous studies indicate that the exudates are used in food and cosmetic industry as thickeners flavors, stabilisers and as emulsifying agents in drugs and cosmetics. Exudates from D. edulis when applied in lotions and creams stabilize emulsion, add smooth to the skin and form protective coating on the skin. The exudates are used in traditional medicine as antibacterial agent and as incense. It is believed that the smoke and sweet smell from the exudates when burning wades off evil spirit.

Snail slime provides novel treatment for scars, skin blemishes
Can rubbing the slime from snails be the next best treatment for scars, skin blemishes, stretch marks?
Before now, the slime of the Giant African Land Snail (GALS) also called African land Tiger snail (Achatina achatina) has been employed by traditional medicine practitioners in the treatment of asthma and hypertension.

But a recent study by Spanish and United States researchers has demonstrated that a cream made from extracts of a European and North American snail (Cryptomphalus aspersa or Helix aspersa) can regenerative the skin, thereby providing novel treatment for scars, skin blemishes and skin ageing.

Indeed, a screen for natural products bearing pharmacological properties has yielded a secretion of the snail (gastropod) Cryptomphalus aspersa, also popularly known as escargot, which possesses skin-regenerative properties.The report, published in Skin Pharmacology & Physiology, the Journal of the International Society of Pharmacological and Biophysical Research outlines some of the cellular and molecular effects underlying this observation and the secretion’s many benefits for human skin.

An early study showed that a secretion from the mollusk Cryptomphalus aspersa induces skin regeneration after wound healing impairment from acute radiodermatitis. However, the molecular bases underlying this effect were unknown.

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