Written by Greg Arnold, DC, CSCS. Complete healing was significantly faster for participating second degree burn victims who applied Centiderm to their wounds compared to those who applied silver sulfadiazine.
Centella asiatica (L.), commonly known as centella, Gotu kola, Asiatic pennywort or Indian pennywort, is a medicinal herbaceous perennial plant native to the wetlands in several southeast Asian countries. It is used in traditional medicine for its wound healing properties. Centiderm, a derivative of C. asiatica, is a topical ointment with antibacterial and wound healing properties
Burns are a common event worldwide and are associated with high rates of disability, death, prolonged hospitalization, and rehabilitation, which all contribute to high health care costs 1. Second-degree burns, defined as being no more than 3 inches in diameter and characterized by blisters 2, are one of the most frequent types of burns that occur in households today. They also require improved methods of treatment 3.
When addressing wounds, silver sulfadiazine is regarded as “the gold standard” due to its antibacterial properties 4. But with side effects that include silver toxicity and black scarring 5, other options for wound healing are needed.
In this 2017 Iranian study 6, 60 second-degree burn victims (15 males, 45 females) between the ages of 21 and 39 were given either Centiderm (30 subjects) or silver sulfadiazine (30 subjects) for a duration of 14 days of daily wound application. Before the study and at days 3, 7, and 14, subjects underwent a physical exam during which wound severity was graded and subjects provided feedback on their wounds 7-9.
The researchers noted statistically significant improvements in wound healing in the Centiderm group versus the silver sulfadiazine group after only 3 days (p < 0.001). After 14 days, the researchers noted the following:
| Centiderm | p-value | Silver sulfadiazide | p-value | |
|---|---|---|---|---|
| Pliability | 90.3% decrease (2.37 to 0.23) | < 0.001 | 56.6% decrease (2.30 to 1.00) | < 0.001 |
| Height | 100% decrease (1.63 to 0.00) | < 0.001 | 60.5% decrease (1.77 to 0.70) | < 0.001 |
| Vascularity | 100% decrease (1.77 to 0.00) | < 0.001 | 57.1% decrease (1.63 to 0.70) | < 0.001 |
| Pigmentation | 100% decrease (1.47 to 0.00) | < 0.001 | 66.5% decrease (1.40 to 0.47) | < 0.001 |
| Pain | 99.1% decrease (8.10 to 0.07) | < 0.001 | 86.2% decrease (8.43 to 1.17) | < 0.001 |
| Dryness | 91.25% decrease (0.80 to 0.07) | < 0.001 | 51.9% decrease (0.83 to 0.40) | < 0.001 |
| Itching | 78.5% decrease (0.93 to 0.20) | < 0.001 | 27.9% decrease (0.97 to 0.70) | < 0.001 |
| Irritation | 96.8% decrease (0.93 to 0.03) | < 0.001 | 55.7% decrease (0.97 to 0.43) | < 0.001 |
After day 14, subjects reported to the clinic daily until complete wound healing was reached. The researchers noted a 31.9% faster time to complete wound healing in the Centiderm group versus the silver sulfadiazide group (14.67 versus 21.53 days, p < 0.001).
For the researchers, “Performing a clinical trial for deeper thickness burning wounds for Centiderm is recommended” and that “We also suggested using Centiderm in dressing form and comparing it with other dressing methods and also with other antiseptic and burn wound healer drugs.”
Source: Saeidinia, Amin, Faeze Keihanian, Ardalan Pasdaran Lashkari, Hossein Ghavvami Lahiji, Mohammadreza Mobayyen, Abtin Heidarzade, and Javad Golchai. “Partial-thickness burn wounds healing by topical treatment: A randomized controlled comparison between silver sulfadiazine and centiderm.” Medicine 96, no. 9 (2017).
Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. Open Access licensed under Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NCND)
Posted May 15, 2017.
Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.
References:
- Aramwit P, Palapinyo S, Srichana T, Chottanapund S, Muangman P. Silk sericin ameliorates wound healing and its clinical efficacy in burn wounds. Archives of dermatological research. 2013;305(7):585-594.
- Clinic M. Burns: First Aid. 2015; Overview of first aid for burns. Available at: http://www.mayoclinic.org/first-aid/first-aid-burns/basics/ART-20056649. Accessed May 10, 2017, 2017.
- Moghbel A, Ghalambor A, Allipanah S. Wound healing and toxicity evaluation of Aloe vera cream on outpatients with second degree burns. Iranian Journal of Pharmaceutical Sciences. 2007;3(3):157-160.
- Hosseini SV, Tanideh N, Kohanteb J, Ghodrati Z, Mehrabani D, Yarmohammadi H. Comparison between Alpha and silver sulfadiazine ointments in treatment of Pseudomonas infections in 3rd degree burns. International Journal of Surgery. 2007;5(1):23-26.
- Hussain S, Ferguson C. Silver sulphadiazine cream in burns. Emergency medicine journal. 2006;23(12):929-932.
- Saeidinia A, Keihanian F, Lashkari AP, et al. Partial-thickness burn wounds healing by topical treatment: A randomized controlled comparison between silver sulfadiazine and centiderm. Medicine. 2017;96(9).
- Martin D, Umraw N, Gomez M, Cartotto R. Changes in subjective vs objective burn scar assessment over time: does the patient agree with what we think? Journal of Burn Care & Research. 2003;24(4):239-244.
- Pastar I, Stojadinovic O, Yin NC, et al. Epithelialization in wound healing: a comprehensive review. Advances in wound care. 2014;3(7):445-464.
- Srivastava P, Durgaprasad S. Burn wound healing property of Cocos nucifera: An appraisal. Indian journal of pharmacology. 2008;40(4):144.
