The wound healing and radioprotective potential of indigenous medicinal plants on the skin

Abstract

Chronic wounds represent a significant public health burden, with an estimated prevalence of 2.21 per 1000 individuals. These wounds present a significant challenge to healthcare systems, particularly in South Africa (SA), where there is a high prevalence of burn wounds resulting from urban and rural fires. Reactive oxygen species (ROS) play a key role in the pathogenesis of chronic wounds, which influence both tissue repair and cellular damage responses. Endothelial and inflammatory cells regulate ROS levels through antioxidant enzymes such as superoxide dismutase (SOD) and glutathione peroxidase (GPx), which detoxify ROS and maintain the redox balance. When there is an imbalance between free radicals and antioxidants, oxidative stress is triggered, leading to impaired cell function and delayed wound healing. Exposure to ionising radiation (IR), particularly during radiotherapy, further amplifies ROS generation, inducing oxidative stress on radiosensitive skin cells, such as keratinocytes. This impairs cell proliferation, migration and re-epithelialisation, thereby leading to chronic wound formation. Current treatment options for chronic wounds, such as conventional dressings, present several challenges, including high risk of infection, skin damage during dressing removal, allergic reactions and irritation. While synthetic radioprotectors such as Amifostine are reported to be effective at reducing radiation-induced damage through free radical scavenging and DNA repair enhancement, their clinical use is constrained by significant side effects.