Effect of Herbal Bioactive Compounds on the Angiogenic Factors and Modulation of Inflammatory Mediators in the Patients with the Deep Second-Degree Burn: A Single-Blinded, Randomized Clinical Trial.

BACKGROUND

Inflammation is the first response to tissue damage. A hematoma occurs when blood leaves the damaged vessels, and platelets play an important role in this process. This study aimed to investigate the effect of herbal bioactive compounds on the angiogenic factors and modulation of inflammatory mediators in deep second-degree burn patients.

METHODS

In a randomized clinical trial, 54 patients were divided into two groups :Swalin ointment (n=31) and silver sulfadiazine (SSD) (n=23). Ointments were administered every other day for 28 days. The concentration of compounds in ointment oils was measured using the GC-MS technique. Serum levels of TNF-α and IL-6 were measured on days 3, 7, and 14, and tissue levels of VEGF, FGF, and PDGF variables were measured on day 14 by ELISA method. Student t-test was used to compare the mean in 2 groups, depending on the type of normal/abnormal distribution. The chi-square test was also used to check the relationship between qualitative variables.

RESULTS

The most common compounds in Swalin ointment were Linoleic acid (41.37%), Elaidic acid (37.45%), and Palmitic acid (9.45%), respectively. The tissue level of VEGF, FGF, and PDGF on the 14th day was higher in the Swalin group compared to the SSD group (<0.001). The serum level of IL-6 and TNF-α in both groups increased until day 7, but gradually decreased on day 14, which was significant in the Swalin group. IL-6 serum level was significant in the Swalin group (<0.001). The serum level of TNF-α was also significant in the Swalin group (<0.001).

CONCLUSION

The present study showed that Swalin ointment, due to the presence of a wide range of fatty acids, especially linoleic acid, leads to the modulation of systemic tissue inflammation. The ingredients of the ointment, especially hemp and sesame oil, increase the tissue level of angiogenic factors and accelerate remodeling and wound healing.