Formulation and Clinical Evaluation of Herbal Based Antimicrobial Wound Dressings for Chronic Ulcers

Abstract

Chronic ulcers including diabetic foot ulcers, venous leg ulcers, and pressure sores represent a major global health burden due to prolonged healing time, high infection rates, and increased healthcare costs. Conventional wound dressings often rely on synthetic antimicrobial agents, which may cause cytotoxicity, allergic reactions, and antimicrobial resistance. Herbal based antimicrobial wound dressings have gained increasing attention because of their bioactive phytochemicals, anti-inflammatory properties, biocompatibility, and potential to promote tissue regeneration. This study aimed to formulate a herbal based antimicrobial wound dressing incorporating standardized extracts of Azedarach indica, Curcuma longa, and Aloe vera and to clinically evaluate its effectiveness in managing chronic ulcers. A mixed method design was adopted involving formulation development, in vitro antimicrobial testing, and clinical evaluation among 200 patients with chronic ulcers. Outcome measures included reduction in wound size, microbial load, pain intensity, and time to complete epithelialization. Structural equation modeling was applied to assess relationships between herbal dressing characteristics and clinical outcomes. The results demonstrated significant antimicrobial activity against Staphylococcus aureus and Pseudomonas aeruginosa, along with enhanced wound contraction and faster healing rates compared to standard gauze dressings. The structural model explained 52 percent of variance in healing outcomes, with herbal bioactive concentration showing a strong positive effect on wound recovery indicators. The findings support the therapeutic potential of herbal based antimicrobial dressings as cost effective and biocompatible alternatives for chronic ulcer management. This research contributes to the development of integrative wound care strategies that combine traditional medicinal knowledge with modern pharmaceutical technology.