**4. Plants with potential use in wound healing**

about the wound healing physiology, a lot of research has focused on the development of therapeutic approaches that would provide an anti-inflammatory and pain relieving activity

An important complication related to wound treatment and healing is infection. Infections are known to significantly increase the treatment costs of wound care [18], which are also the reason that different strategies are being developed for their prevention [19]. Due to the impact of primary and secondary infections on the wound healing, which increase local inflammation, and hence lead to significant tissue destruction, prevention of their occurrence remains one of the main targets of wound dressing development [20]. An ideal medicine for the prevention of wound infection should therefore have antimicrobial activities, while also stimulating the body's natural immune system without damaging the surrounding healthy tissue [21].

Most wounds induce some level of pain sensation. Pain relates to patient's discomfort, release of stress hormones and often reduces the patients' overall quality of life. Hindered mobility and psychological issues connected with pain-induced stress lead to a less effective wound healing. According to McGuire et al. [22], chronic pain lowers the patients' capability of healing, thereby prolonging the overall recovery process [23]. Suitable and effective pain management can lead to an earlier release from the hospital, stress reduction and a general better reintegration into the community. All mentioned lead to facilitation of wound healing, while at the same time minimizing the risk for development of chronic pain, and finally in lowered treatment costs [24].

**Figure 2.** A diagram showing the most important beneficial properties that are desired in wound treatment (and some of the already known plants used in traditional medicine for this purpose). Anti-inflammatory: *Achillea* [28], *Aloe vera* [29], *Avena* [30], *Azadirachta indica* [31], *Calendula officinalis* [32], *Cedrus deodara* [33], *Chamomilla recutita* [34], *Commiphora myrrha* [35], *Curcuma longa* [36], *Echinacea* [37], *Euphorbia hirta* [38], *Hypericum perforatum* [39], *Rosmarinus officinalis* [40]. Antimicrobial: *Achillea* [28], *Angelica sinensis* [41], *Azadirachta indica* [31], *Calendula officinalis* [32], *Cedrus deodara* [33], *Chamomilla recutita* [34], *Commiphora myrrha* [35], *Curcuma longa* [36], *Echinacea* [42], *Hypericum perforatum* [43]. Analgesic: *Angelica sinensis* [41], *Commiphora myrrha* [44], *Curcuma longa* [36], *Euphorbia hirta* [38], *Hypericum perforatum* [43].

Antioxidant: *Chamomilla recutita* [34], *Ginkgo biloba* [45].

to wound dressings [17].

124 Herbal Medicine

For thousands of years, we looked to nature for various types of medicinal treatments and plant-based systems continue to play an essential role in the primary health care of many less-developed, as well as developing countries [46]. Many plants and various preparations thereof have been used traditionally in relation to wound treatment, especially due to their immense potential to affect the wound healing process [65]. Plant-derived extracts and/or isolates induce healing and tissue regeneration through multiple connected mechanisms, which often have a synergistic effect on the overall healing efficiency [47]. Many plant-derived medicines (commonly called as phytomedicines) are affordable and cause minimal unwanted side effects [48]. Nevertheless, increasing awareness of their potential activities, especially considering the possible combinations of various plant-derived molecules, which could induce toxic effects as well, points out the need for a systematic approach towards their evaluation before efficient introduction to wound care (or other fields of medicine) [49]. In recent years, extensive research has been carried out in the area of wound healing and management through plant-derived medicinal products [38].

The following subchapters review the key details related to the potential use of medicinal plants in wound healing.
