Clinical Considerations

General comments

– Every injury produces a wound, that is, a tissue defect that the body must seal off by fibrous tissue scarring and skin regeneration.

– In primary wound healing, the wound heals with a minimal amount of scar formation within a few days. This requires secure wound coverage, cleanliness, and a good blood supply to the wound.

– In secondary wound healing, the healing process is slower and more complicated. Bacterial invasion is usually involved. Wounds that do not begin to heal within 8 weeks are called chronic wounds, e. g., leg ulcers, diabetic foot ulcers, bed sores (decubitus ulcers), and surgical wounds.

Herbal treatment measures

– All of the recommended herbal remedies are applied locally as watery extracts or ointments. Wet compresses are the preferred vehicle for cleaning wounds and stimulating the healing process. Once the wound starts to heal, the patient can switch to ointments, which are sparingly applied to the edges of the wound.

– Chamomile flower extracts are beneficial in all phases of wound healing.

– An oily calendula flower extract should preferably be used if there is more severe involvement.

– Small, circumscribed wounds heal quickly when treated with St. John’s wort oil.

– Compresses soaked in arnica tincture are recommended for wounds with a slimy and adhesive coating, poor granulation, and first signs of lymphangitis. It contains helenalin, a compound known to cause contact allergies, with increased inflammation in susceptible individuals. Spanish Arnica montana varieties contain only small quantities of the compound and should be used wherever possible and available. Before using arnica, the potential risk should be carefully weighed against the expected benefits of treatment, and the duration of use should be limited. Study data supporting this use are still lacking.

– Fresh plant juice extracted from purple echinacea has immunomodulatory constituents. Echinacea stimulates granulation for new tissue.

Clinical value of herbal medicine: Every attempt should be made to treat the underlying disease. The recommended herbal preparations are safe adjunctive treatment measures to accelerate wound healing.

Recommended Herbal Remedies and Range of Applications

• Immunostimulant: Calendula stimulates the immune system through macrophages and granulocytes, promotes the formation of new tissue, and prevents the spread of infection.

The active principles in chamomile flowers are present in active form only in alcoholic extracts and corresponding essences.

– Contraindications: Arnica, calendula, and chamomile should not be used by individuals with a known allergy to arnica and other composite plants. Arnica should not be used by children under 12 years of age.

– Dosage and administration

• Compresses: Wet with a mixture of calendula tincture and Ringer’s solution (1: 10).

• Small wounds: Apply Hypericum oil directly to the wound three times a day. The Hypericum oil should be of a rich red color to be effective.

• The above formulations or commercial products are applied locally, several times a day. Compresses soaked with the plant extract are applied for 1 to 2 hours, 3 times daily. Each compress should be left on for only around 15 to 20 minutes (until it becomes warm and dry), then replaced by a fresh one. Commercial products should be used as directed by the manufacturer.

Arnica should not be allowed to come in contact with the eye or applied to the eye region. Arnica-containing ointments should not be applied to mucous membranes or open wounds. The hands should be washed after using arnica products.

– Side effects

• Chamomile flower: Although rare, contact allergies can occur. This is, in most cases, attributable to adulteration with corn chamomile.