Skin Wound Healing: from Mediterranean ethnobotany to evidence based phytotherapy

Phytotherapy plays an important role in wound healing. Medicinal plants have represented for thousands of years the only remedy for wound care, and still maintain an important therapeutic role thanks to peculiar and desirable features of plant phytocomplexes. The use of herbal preparations exploiting synergistic and multitasking activities is distinctive of phytotherapy as a branch of pharmacology and could be alternative, more often complementary, to the use of monomolecular synthetic drugs. The European Medicines Agency (EMA), as well as World Health Organization (WHO) and European Scientific Cooperative on Phytotherapy (ESCOP), confirm that one of the most frequent indication for which many medicinal plants are used in the European Community and in the rest of the world, is the treatment of skin disorders and minor wounds. The study of medicinal plants used in wound healing has its origins in the ethnobotanical knowledge and in folk medicine. Ethnobotany encompasses both wild and domestic species, and is rooted in observation, relationship, needs and traditional ways of knowing. Various ethnobotanical investigations that took place in Italy and in Greece confirmed the use of many species enlisted by EMA, ESCOP and WHO for use in wound healing. The interviewed subjects provided important practical details about the use of medicinal plants for the treatment of tissue lesions and they also described how every single plant, as well as every preparation, is destined to a specific type of wound. This work summarizes the medicinal plants used in Mediterranean countries, particularly Italy and Greece, for wound healing, reporting mechanisms of action, clinical efficacy and peculiar characteristics. These data provide the rationale for using different natural remedies on different types of wounds, showing that local health seeking strategies can help in resolving wound healing problems.