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      Partial-thickness burn wounds healing by topical treatment : A randomized controlled comparison between silver sulfadiazine and centiderm

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          Abstract

          Background:

          Burns are common event and associated with a high incidence of death, disability, and high costs. Centella asiatica (L.) is a medicinal herb, commonly growing in humid areas in several tropical countries that improve wound healing. On the basis of previous studies, we compared the efficacy of Centiderm versus silver sulfadiazine (SSD) in partial thickness burning patients.

          Methods:

          Study population comprised burn victims referred to Velayat Burning Hospital at Rasht, Iran. The intervention group received Centiderm and control group SSD cream. Burn wounds were treated once daily at home. All of the wounds were evaluated till complete healing occurred and at the admission, days 3, 7, 14 objective signs; visual acuity score (VAS) and subjective signs were recorded. Re-epithelialization time and complete healing days were recorded. We used random fixed block for randomization. The randomization sequence was created using the computer. Patients and burning specialist physician were blinded.

          Results:

          Seventy-five patients randomized into 2 groups; (40 patients: Centiderm group; 35 patients: SSD group). The mean age of them was 30.67 ± 9.91 years and 19 of them were male (31.7%). Thirty patients in Centiderm and 30 patients in SSD group were analyzed. All of objective and subjective signs and mean of re-epithelialization and complete healing were significantly better in Centiderm group rather than SSD group ( P < 0.05). There was no infection in Centiderm group.

          Conclusions:

          We showed that use of Centiderm ointment not only improved the objective and subjective signs in less than 3 days, but also the re-epithelialization and complete healing rather than SSD without any infection in the subjects.

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          Most cited references38

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          Is Open Access

          Pharmacological Review on Centella asiatica: A Potential Herbal Cure-all

          In recent times, focus on plant research has increased all over the world. Centella asiatica is an important medicinal herb that is widely used in the orient and is becoming popular in the West. Triterpenoid, saponins, the primary constituents of Centella asiatica are manly believed to be responsible for its wide therapeutic actions. Apart from wound healing, the herb is recommended for the treatment of various skin conditions such as leprosy, lupus, varicose ulcers, eczema, psoriasis, diarrhoea, fever, amenorrhea, diseases of the female genitourinary tract and also for relieving anxiety and improving cognition. The present review attempts to provide comprehensive information on pharmacology, mechanisms of action, various preclinical and clinical studies, safety precautions and current research prospects of the herb. At the same time, studies to evaluate the likelihood of interactions with drugs and herbs on simultaneous use, which is imperative for optimal and safe utilization of the herb, are discussed.
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            Chemical, pharmacological and clinical profile of the East Asian medical plant Centella asiatica.

            Centella asiatica is a medicinal plant that has been in use since prehistoric times. Its active constituents include pentacyclic triterpene derivatives. Studies have been conducted in particular to investigate the madecassosides and asiaticosides. In common with most traditional phytotherapeutic agents, Centella asiatica is used in folk medicine to treat a wide range of indications. In contrast to other medicinal plants, however, Centella asiatica has been subjected to quite extensive experimental and clinical investigations. Studies done in accordance with standardized scientific criteria have shown it to have a positive effect in the treatment of venous insufficiency and striae gravidarum. Centella asiatica also appears to be effective in the treatment of wound healing disturbances. At the present time, clinical studies aimed at investigating the sedative, analgesic, antidepressive, antimicrobial, antiviral and immunomodulatory effects that have been demonstrated experimentally, are still lacking. However, the therapeutic potential of this plant in terms of its efficacy and versatility is such that further detailed research would appear worthwhile.
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              In vitro and in vivo wound healing activity of asiaticoside isolated from Centella asiatica.

              The activity of asiaticoside, isolated from Centella asiatica, has been studied in normal as well as delayed-type wound healing. In guinea pig punch wounds topical applications of 0.2% solution of asiaticoside produced 56% increase in hydroxyproline, 57% increase in tensile strength, increased collagen content and better epithelisation. In streptozotocin diabetic rats, where healing is delayed, topical application of 0.4% solution of asiaticoside over punch wounds increased hydroxyproline content, tensile strength, collagen content and epithelisation thereby facilitating the healing. Asiaticoside was active by the oral route also at 1 mg/kg dose in the guinea pig punch wound model. It promoted angiogenesis in the chick chorioallantoic membrane model at 40 microg/disk concentration. These results indicate that asiaticoside exhibits significant wound healing activity in normal as well as delayed healing models and is the main active constituent of Centella asiatica.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                March 2017
                03 March 2017
                : 96
                : 9
                : e6168
                Affiliations
                [a ]Medicinal Plants Research Center of Student Basij, Guilan University of Medical Sciences, Rasht
                [b ]Cardiology Department & Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad
                [c ]Pharmacognosy Department and Research and Development Center of Plants and Medicinal Chemistry
                [d ]Fellowship of Burn Surgery, Velayat Hospital
                [e ]Social Medicine Department
                [f ]Dermatology Department, Guilan University of Medical Sciences, Rasht, Iran.
                Author notes
                []Correspondence: Ardalan Pasdaran Lashkari, Department of Pharmacognosy, Faculty of Pharmacy, Guilan University of Medical Sciences, Fouman-Saravan Autobahn, Lakan Road, Rasht 416351655, Iran (e-mail: ardalanpasdar@ 123456gmailcom ); Faeze Keihanian, MD, Cardiology Department & Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran (e-mail: faezekeihanian@ 123456yahoo.com ).
                Article
                MD-D-15-05915 06168
                10.1097/MD.0000000000006168
                5340444
                28248871
                68a80b01-2119-4a67-a5fa-70886eb13bfa
                Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                : 28 December 2015
                : 24 January 2017
                : 30 January 2017
                Categories
                7100
                Research Article
                Clinical Trial/Experimental Study
                Custom metadata
                TRUE

                burning,centella asiatica,partial thickness,silver sulfadiazine,wound

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