Written by Taylor Woosley, Staff Writer. No significant difference was noted between the mean (95% CI) healing times for the SSD group and the BCF group, which were 10.94 days and 10.73 days, respectively (p = 0.71).
According to the World Health Organization, it is estimated that each year approximately 11 million people suffer from burn wounds1. Burn patients are increasingly susceptible to colonization by endogenous and exogenous microorganisms after having lost skin, which acts as a primary protective barrier to environmental contaminants2. Many factors such as oxygenation, infection, and nutrition potentially can influence burn progression and disrupt repair with unbalanced release of various growth factors and cytokines3.
Boswellia carteri, from which frankincense is extracted, has a wide application in medicine4. The biological activities of Boswellia have been attributed to its essential oils and non-volatile diterpenoids and triterpenoids5. Previous research has shown that Boswellia-based creams and gels affect various phases of wound healing, including collagen synthesis and wound contraction, leading to a faster healing process6.
Badr et al. conducted a double-blind, randomized study to evaluate the effectiveness of a traditionally originated and pharmaceutically evaluated formulation from Boswellia carteri (BCF) versus silver sulfadiazine (SSD) cream 1% in the treatment of second-degree burns. Each 100 g of the BCF 40% product contained 0.72 mg of β-boswellic acid. Study inclusion consisted of being aged 20 to 60 years old with second-degree burn wounds of thermal origin affecting up to 5% of total body surface area (TBSA). Participants (n=54) were randomly allocated to either the SSD cream 1% group (n=26) or the BCF 40% group (n=28).
After subject admission and primary preparation, burn wounds were evaluated by an expert emergency burn physician and then were covered in either the SSD or BCF. Dressings were changed every two days until the wound was completely healed, with the same physician monitoring the entire healing process. Photographs of the wounds were taken every 2 days and the margins of the wound were marked by a surgeon. The primary outcome was the amount of time until complete wound healing and was evaluated by Kaplan-Meier survival analysis. The survival times of the two groups was compared using the log-rank test. The independent samples t test was utilized to compare healing indices and the total number of healed patients between the two groups at each time interval.
A total of 17 subjects from the SSD group and 15 subjects from the BCF group completed the study. The groups were similar in age (p = 0.75), weight (p = 0.79), sex (p = 0.46), cause of burn (p = 0.69), and site of wounds (p = 0.05). However, the TBSA burnt for the SSD group was 1.70 ± 0.68%, which was significantly greater than the BCF group 1.20 ±0.41% (p = 0.01). There was no significant difference between the mean (95% CI) healing times for the SSD group and the BCF group, which were 10.94 days and 10.73 days, respectively (p = 0.71). The Cox proportional hazards model revealed no significant difference between SSD and BCF for healing effect (adjusted hazard ratio=0.9 [95% CI: 0.4-1.9]).
Results of the study show that a BCF 40% product exhibited healing activities comparable to SSD in treating second-degree burn wounds. Further studies on different concentrations of Boswellia carteri are necessary to better comprehend its wound healing abilities.
Source: Badr, Parmis, Suleiman Afsharypuor, Hamid Reza Tohidinik, Ali Akbar Mohammadi, and Saeid Daneshamouz. “Burn Wound Healing Effect of a Sterilized Traditional Formulation of Boswellia carteri vs. Silver Sulfadiazine Cream 1% in Patients Presenting Second-degree Burn Wounds: A Randomized, Double-blind Clinical Trial.” Iranian Journal of Medical Sciences 48, no. 2 (2023): 137.
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Posted June 7, 2023.
Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.
References:
- Markiewicz-Gospodarek A, Kozioł M, Tobiasz M, Baj J, Radzikowska-Büchner E, Przekora A. Burn Wound Healing: Clinical Complications, Medical Care, Treatment, and Dressing Types: The Current State of Knowledge for Clinical Practice. Int J Environ Res Public Health. Jan 25 2022;19(3)doi:10.3390/ijerph19031338
- Thompson MA, Zuniga K, Sousse L, Christy R, Gurney CJ. The Role of Vitamin E in Thermal Burn Injuries, Infection, and Sepsis: A Review. J Burn Care Res. Nov 2 2022;43(6):1260-1270. doi:10.1093/jbcr/irac100
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- Byler KG, Setzer WN. Protein Targets of Frankincense: A Reverse Docking Analysis of Terpenoids from Boswellia Oleo-Gum Resins. Medicines (Basel, Switzerland). Aug 31 2018;5(3)doi:10.3390/medicines5030096
- Badr P, Afsharypuor S, Tohidinik HR, Mohammadi AA, Daneshamouz S. Burn Wound Healing Effect of a Sterilized Traditional Formulation of Boswellia carteri vs. Silver Sulfadiazine Cream 1% in Patients Presenting Second-degree Burn Wounds: A Randomized, Double-blind Clinical Trial. Iran J Med Sci. Mar 2023;48(2):137-145. doi:10.30476/ijms.2022.91853.2307
