IMEMR
66.92
Volume 4, Issue 4 (2023)                   J Clinic Care Skill 2023, 4(4): 197-205 | Back to browse issues page
Article Type:
Original Research |

Print XML PDF HTML

History

How to cite this article
Kazemi Dermenaki Farahani R, Rahzani K, Hekmat Pu D, Rostami A. Effect of Oral Extract of Centella asiatica on Burn Pain and Wound Healing; A Randomized Controlled Trial. J Clinic Care Skill 2023; 4 (4) :197-205
URL: http://jccs.yums.ac.ir/article-1-214-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Rights and permissions
1- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
2- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran , k.rahzani@yahoo.com
3- Valiasr Educational and Visual Center, Arak University of Medical Sciences, Arak, Iran
* Corresponding Author Address: School of Nursing, Arak University of Medical Sciences, A'lam-Al-Hoda Street, Shahid Shiroodi Street, Arak, Markazi Province, Iran. Postal Code: 3819693345
Abstract   (1503 Views)
Aims: Burns and wounds caused by it are a global injury. Finding natural ingredients to accelerate wound healing in patients with fewer side effects could be valuable. This study aimed to determine the effect of oral Centella asiatica extract on the healing of pain and wound of burn in patients.
Materials & Methods: This study is a clinical trial in which 76 patients hospitalized in the burn department were randomly divided into two intervention (n=38) and control (n=38) groups. The intervention group, in addition to the usual antibiotic treatments, received capsules containing 200mg of Centella asiatica twice daily, and the control group received capsules containing 200mg of starch twice daily. Data collection tools were Bates-Jensen Wound Assessment tool and Visual Analog Scale. Patients' pain and wound healing status were examined at different time of the study.
Findings: The mean burn pain score showed a significant improvement in the intervention group compared to the control group (p<0.001). The average wound healing score did not show significant improvement in the intervention group compared to the control group (p=0.561). However, size (p=0.023), the degree of destruction of the underlying tissues (p=0.032), the amount of necrotic tissue (p=0.015), and the amount of granulation tissue (p=0.001) improved significantly in the intervention group. In addition, the peripheral tissue edema in the control group decrease significantly compared to the intervention group (p=0.008).
Conclusion: Oral extract of Centella asiatica reduces pain in burn patients. However, it does not affect wound healing, although it improves some wound healing indicators.
 
Keywords:

References
1. Rebarczyk M, Schafer J, Elm C, Sarvepalli S, Vaswani P, Balhara S, et al. A systemic review of burn injuries in low and middle income countries: Epedemiology in WHO defiened Afrecian region. Afr J Emerg Med. 2017;7(1):30-7. [Link] [DOI:10.1016/j.afjem.2017.01.006]
2. Gilbert AD, Rajha E, El Khuri C, Chebl RB, Mailhac A, Makki M, El Sayed M. Epidemiology of burn patients presenting to a tertiary hospital emergency department in Lebanon. Burns. 2018;44(1):218-25. [Link] [DOI:10.1016/j.burns.2017.06.015]
3. Dehghani M, Hakimi H, Mousazadeh S, Zeynali J, Samimian S. The relationship between pain and anxiety throughout dressing among burn patients. J Holist Nurs Midwifery. 2014;24(4):30-7. [Persian] [Link]
4. Saberi M, Fatemi M, Soroush M, Masoumi M, Niazi M. Burn epidemiology in Iran: a meta-analysis study. Iran J Surg. 2016;24(1):47-61. [Persian] [Link]
5. Wang Y, Beekman J, Hew J, Jackson S, Issler-Fisher AC, Parungao R, et al. Burn injury: challenges and advances in burn wound healing, infection, pain and scarring. Adv Drug Deliv Rev. 2018;123:3-17. [Link] [DOI:10.1016/j.addr.2017.09.018]
6. Griggs C, Goverman J, Bittner EA, Levi B. Sedation and pain management in burn patients. Clin Plast Surg. 2017;44(3):535-40. [Link] [DOI:10.1016/j.cps.2017.02.026]
7. Gholami E, Mohammad Hossini S, Moradian F, Manzouri L, Karimi Z. Effect of pilates on pain control and wound healing in second degree burn patients; a randomized clinical trial. J Clin Care Skill. 2023;4(2):71-5. [Link]
8. Singer AJ, Beto L, Singer DD, Williams J, Thode Jr HC, Sandoval S. Association between burn characteristics and pain severity. Am J Emerg Med. 2015;33(9):1229-31. [Link] [DOI:10.1016/j.ajem.2015.05.043]
9. James DL, Jowza M. Principles of burn pain management. Clin Plast Surg. 2017;44(4):737-47. [Link] [DOI:10.1016/j.cps.2017.05.005]
10. Belba MK, Petrela EY, Belba AG. Epidemiology and outcome analysis of sepsis and organ dysfunction/failure after burns. Burns. 2017;43(6):1335-47. [Link] [DOI:10.1016/j.burns.2017.02.017]
11. Outwater AH, Van Braekel T. Prehospital care of burn injuries in Africa: a review, 1990-2018. Burns. 2020;46(8):1737-45. [Link] [DOI:10.1016/j.burns.2019.08.009]
12. Gauffin E, Öster C, Sjöberg F, Gerdin B, Ekselius L. Health-related quality of life (EQ-5D) early after injury predicts long-term pain after burn. Burns. 2016;42(8):1781-8. [Link] [DOI:10.1016/j.burns.2016.05.016]
13. Ghorbani F, Shiri M, Mortaqhy Ghasemi M, Ansari P, Mohammadi F. Epidemiologic study of burn patients hospitalized in Mousavi Hospital, Zanjan 2010- 2012. Prev Care Nurs Midwifery J. 2016;5(2):65-74. [Persian] [Link]
14. Bayuo J, Agbenorku P. Nurses' perceptions and experiences regarding Morphine usage in burn pain management. Burns. 2015;41(4):864-71. [Link] [DOI:10.1016/j.burns.2014.10.031]
15. Ghezeljeh TN, Ardebili FM, Rafii F. The effects of massage and music on pain, anxiety and relaxation in burn patients: Randomized controlled clinical trial. Burns. 2017;43(5):1034-43. [Link] [DOI:10.1016/j.burns.2017.01.011]
16. Seyyed-Rasooli A, Salehi F, Mohammadpoorasl A, Goljaryan S, Seyyedi Z, Thomson B. Comparing the effects of aromatherapy massage and inhalation aromatherapy on anxiety and pain in burn patients: A single-blind randomized clinical trial. Burns. 2016;42(8):1774-80. [Link] [DOI:10.1016/j.burns.2016.06.014]
17. Lalegani H, Esmaili S, Safdari A. The effects of breathing techniques on pain intensity of burn dressing. J Clin Nurs Midwifery. 2014;2(4):61-8. [Persian] [Link]
18. Mazlom R, Hosseini Amiri M, Manzari Z S, Tavoosi H. Effect of transcranial direct current stimulation on pain intensity and quality of burn dressing. J Mazandaran Univ Med Sci. 2015;24(120):75-87. [Persian] [Link]
19. Aleebrahim-Dehkordy E, Tamadon MR, Nasri H, Baradaran A, Nasri P, Beigrezaei S. Review of possible mechanisms of analgesic effect of herbs and herbal active ingredient. J Young Pharm. 2017;9(3):303-6. [Link] [DOI:10.5530/jyp.2017.9.60]
20. Hu S, Belcaro G, Hosoi M, Feragalli B, Luzzi R, Dugall M. Postpartum stretchmarks: repairing activity of an oral Centella asiatica supplementation (Centellicum®). Minerva Ginecol. 2018;70(5):629-34. [Link] [DOI:10.23736/S0026-4784.18.04254-5]
21. Ahmed AS, Taher M, Mandal UK, Jaffri JM, Susanti D, Mahmood S, et al. Pharmacological properties of Centella asiatica hydrogel in accelerating wound healing in rabbits. BMC Complement Altern Med. 2019;19:213. [Link] [DOI:10.1186/s12906-019-2625-2]
22. Boekema B, Pool L, Ulrich M. The effect of a honey based gel and silver sulphadiazine on bacterial infections of in vitro burn wounds. Burns. 2013;39(4):754-9. [Link] [DOI:10.1016/j.burns.2012.09.008]
23. Ter Horst B, Chouhan G, Moiemen NS, Grover LM. Advances in keratinocyte delivery in burn wound care. Adv Drug Deliv Rev. 2018;123:18-32. [Link] [DOI:10.1016/j.addr.2017.06.012]
24. Shahid F, Ismail M, Khan S. Assessment of quality of life in post burn survivors: a cross-sectional single-center first validation study from Pakistan. Burns Open. 2018;2(1):35-42. [Link] [DOI:10.1016/j.burnso.2017.08.003]
25. Babajafari S, Akhlaghi M, Mazloomi SM, Ayaz M, Noorafshan A, Jafari P, et al. The effect of isolated soy protein adjunctive with flaxseed oil on markers of inflammation, oxidative stress, acute phase proteins, and wound healing of burn patients; a randomized clinical trial. Burns. 2018;44(1):140-9. [Link] [DOI:10.1016/j.burns.2017.05.014]
26. Prasanna M, Mishra P, Thomas C. Delayed primary closure of the burn wounds. Burns. 2004;30(2):169-75. [Link] [DOI:10.1016/j.burns.2003.09.028]
27. Vowden K, Vowden P. Wound dressings: principles and practice. Surgery (Oxford). 2017;35(9):489-94. [Link] [DOI:10.1016/j.mpsur.2017.06.005]
28. Ramamoorthy R, Muthalagu M, Andra S, Ravichandran B, Narayanasamy M. Investigation on antimicrobial, antioxidant and cytotoxicity properties of triple bark extract formulated using traditional medicinal plants. SN Appl Sci. 2019;1:772. [Link] [DOI:10.1007/s42452-019-0791-y]
29. Bahmani M, Shirzad H, Majlesi M, Shahinfard N, Rafieian-Kopaei M. A review study on analgesic applications of Iranian medicinal plants. Asian Pac J Trop Med. 2014;7:S43-53. [Link] [DOI:10.1016/S1995-7645(14)60202-9]
30. Taghizadeh M, Yasa N, Naqinezhad A, Ahvazi M. Review of Centella asiatica (L.) urban. J Med Plants. 2004;3(12):1-8. [Persian] [Link]
31. Choochuay K, Sawatdee S, Chanthorn W. The efficacy of topical spray containing Centella asiatica extract on excision wound healing in rats. Asian J Pharm Sci. 2016;1(11):132-3. [Link] [DOI:10.1016/j.ajps.2015.11.091]
32. Somboonwong J, Kankaisre M, Tantisira B, Tantisira MH. Wound healing activities of different extracts of Centella asiatica in incision and burn wound models: an experimental animal study. BMC Complement Altern Med. 2012;12(1):103. [Link] [DOI:10.1186/1472-6882-12-103]
33. Wu F, Bian D, Xia Y, Gong Z, Tan Q, Chen J, et al. Identification of major active ingredients responsible for burn wound healing of Centella asiatica herbs. Evid Based Complement Altern Med. 2012;2012:848093. [Link] [DOI:10.1155/2012/848093]
34. Qureshi M, Jahan N, Muhammad S, Mohani N, Wazir A, Baig IA, et al. Evaluation of neuropharmacological, analgesic and anti-inflammatory effects of the extract of Centella asiatica (Gotu kola) in mice. Afr J Pharm Pharmacol. 2015;9(41):995-1001. [Link] [DOI:10.5897/AJPP2015.4428]
35. Saha S, Guria T, Singha T, Maity TK. Evaluation of analgesic and anti-inflammatory activity of chloroform and methanol extracts of Centella asiatica Linn. ISRN Pharmacol. 2013;2013:789613. [Link] [DOI:10.1155/2013/789613]
36. BabashahiKohanestani F, Ahmadi F, Memarian R. The effect of Lavender aromatherapy program on the pain intensity of patients with AML undergoing chemotherapy. Nurs Midwifery J. 2013;11(3):180-6. [Persian] [Link]
37. Delbo M, Calapai G. Assessment report on Centella asiatica (L.) Urban, herba. London, UK: European Medicines Agency; 2010. [Link]
38. Arbastan MA, Rahzani K, Hekmatpou D, Alizadeh SA, Rafiei M, Malekirad AA. The effect of oral melissa officinalis on serum oxidative stress and second degree burn wounds healing. Health. 2014;6(18):2517. [Link] [DOI:10.4236/health.2014.618290]
39. Bikmoradi A, Zafari A, Oshvandi K, Mazdeh M, Roshanaei G. Effect of progressive muscle relaxation on severity of pain in patients with multiple sclerosis: a randomized controlled trial. J Hayat. 2014;20(1):26-37. [Persian] [Link]
40. Micheli L, Di Cesare Mannelli L, Mattoli L, Tamimi S, Flamini E, Garetto S, et al. Intra-articular route for the system of molecules 14G1862 from Centella asiatica: Pain relieving and protective effects in a rat model of osteoarthritis. Nutrients. 2020;12(6):1618. [Link] [DOI:10.3390/nu12061618]
41. Sarker S, Rahman SM, Kabir MZ, Islam MR, Al Azad MS, Rahman S, et al. Antinociceptive activity evaluation of leaves of Centella asiatica and Zizyphus mauritiana. Adv Natur Appl Sci. 2014;8(2):96-102. [Link]
42. Somchit M, Sulaiman M, Zuraini A, Samsuddin L, Somchit N, Israf D, et al. Antinociceptive and antiinflammatory effects of Centella asiatica. Indian J Pharm. 2004;36(6):377-80. [Link]
43. Saeidinia A, Keihanian F, Lashkari AP, Lahiji HG, Mobayyen M, Heidarzade A, et al. Partial-thickness burn wounds healing by topical treatment: a randomized controlled comparison between silver sulfadiazine and centiderm. Medicine. 2017;96(9):e6168. [Link] [DOI:10.1097/MD.0000000000006168]
44. Cotellese R, Hu S, Belcaro G, Ledda A, Feragalli B, Dugall M, et al. Centella asiatica (Centellicum®) facilitates the regular healing of surgical scars in subjects at high risk of keloids. Minerva Chir. 2018;73(2):151-6. [Link] [DOI:10.23736/S0026-4733.18.07666-6]
45. Damkerngsuntorn W, Rerknimitr P, Panchaprateep R, Tangkijngamvong N, Kumtornrut C, Kerr SJ, et al. The effects of a standardized extract of Centella asiatica on postlaser resurfacing wound healing on the face: A split-face, double-blind, randomized, placebo-controlled trial. J Altern Complement Med. 2020;26(6):529-36. [Link] [DOI:10.1089/acm.2019.0325]
46. Park JH, Choi JY, Son DJ, Park EK, Song MJ, Hellström M, et al. Anti-inflammatory effect of titrated extract of Centella asiatica in phthalic anhydride-induced allergic dermatitis animal model. Int J Mol Sci. 2017;18(4):738. [Link] [DOI:10.3390/ijms18040738]
47. Kuo Y-S, Chien H-F, Lu W. Plectranthus amboinicus and Centella asiatica cream for the treatment of diabetic foot ulcers. Evid Based Complement Altern Med. 2012;2012:418679. [Link] [DOI:10.1155/2012/418679]