Therapeutic potential of herbal topical agents in evidence-based wound care: a systematic research review

Abstract Herbal interventions are increasingly investigated for wound infection due to their potential for antimicrobial, antioxidant, anti-inflammatory, tissue-repair and angiogenic activities. Despite this, their clinical relevance is uncertain owing to substantial heterogeneity in botanical materials, phytochemical composition, formulations, experimental models and level of evidence. This systematic review was conducted in accordance with PRISMA 2020. Literature published between 2000 and 2025 was systematically searched in PubMed for original peer-reviewed studies evaluating herbal extracts or purified phytoconstituents, alone or incorporated into topical formulations, for wound infection. In vitro, animal, observational, and clinical studies were included and critically interpreted as per the evidence. Other than this, data on botanical authentication, extraction, standardization, bioactive constituents, wound type, formulation characteristics, and antimicrobial and antifilm activity, efficacy and safety were extracted. The evidence indicated that selected herbal interventions can modulate multiple processes involved in wound repair, including inflammation, oxidative stress, angiogenesis, fibroblast activity, collagen deposition, re-epithelialization, and microbial growth. Nevertheless, substantial heterogeneity in plant sources, extraction methods, concentrations, formulations, wound models, and outcome measures limited direct comparison. Evidence for activity against clinically relevant biofilms and chronic wounds was comparatively limited, while clinical evidence remained less extensive than preclinical evidence. Advanced formulations may improve delivery and wound-site retention, although their independent contribution to therapeutic efficacy requires further clarification. Herbal extracts and phytoconstituents represent potential candidates for topical wound management; however, current evidence does not support their routine replacement of established therapies. Standardized preparations, reproducible formulations, rigorous safety evaluation, clinically relevant chronic-wound models, and adequately powered clinical trials are required for translation into evidence-based wound care.