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Q: help for a mother to support her 2 yo daughter cope with 80% burns to her body ( Answered 5 out of 5 stars,   2 Comments )
Question  
Subject: help for a mother to support her 2 yo daughter cope with 80% burns to her body
Category: Health > Children
Asked by: jo64-ga
List Price: $100.00
Posted: 02 Jan 2004 02:46 PST
Expires: 01 Feb 2004 02:46 PST
Question ID: 292293
I am hoping you will be able to find some ideas or good web sites on
alternative pain and anxiety management for a 2 1/2 year old with
burns to 80% of her body.
I am looking for ideas on how my friend, Caro can help her
daughter, Sophie, a 2 year & 8 mth old little girl, who has suffered
burns to 80% of her body. These burns occurred as a result of an
accident in December when a car ran
into her day care center and ran over her while she was asleep, the
car then burst into flames resulting in the burns. Sophie has been
mainly unconscious since the event and has undergone numerous
procedures and operations including the amputation of both feet and of
most of one hand. Against all odds Sophie is alive and fighting. Four
days ago Sophie started to have periods of consciousness where she
would respond to her Mum, Caro, her Dad Ron and her 4 year old brother
Mitchel. In these short periods of consciousness Caro and Ron read her
stories which she chooses by nodding when they hold up the one she
wants. Sophie has been responding to visualisation ideas and deep
breathing exercises to reduce her anxiety. The first couple of times
Sophie became conscious her heart rate would go high and Caro would
explain that she is sick in hospital. Caro has used visualisation such
as imagining a nice safe place where Mummy and Daddy give you big hugs
etc and others to help her manage the pain such as putting the pain in
a big bubble and floating it away etc.
My question is: finding successful techniques and ideas on how others
have helped their children with acute and chronic pain and anxiety. I
guess at this stage we are looking at the idea of accepting the pain
rather than fighting it? Specifically I guess we are looking for ways
a mother can help emotionally with her daughter as well as other
ideas. Actually anything that might help!!  please ask me questions if
you want more direction for this research.
i appreciate you reserching this for Caro and Ron
Kind regards Joanne
Answer  
Subject: Re: help for a mother to support her 2 yo daughter cope with 80% burns to her body
Answered By: belindalevez-ga on 03 Jan 2004 05:21 PST
Rated:5 out of 5 stars
 
<Coping with burns.

Support groups.

There are a number of support groups providing help and advice for
burn survivors and their families.

Burn Survivors Online
Burn Survivors Online is a service of the World Burn Foundation, an
international non-profit organisation. It provides information and
support for burn survivors and their families throughout the world. It
includes a chat room, discussion forum, articles, stories, health
information, events guide, product reviews and links to other sources
of information.
http://www.burnsurvivorsonline.com/

Children?s Burn Foundation.
This foundation provides financial resources to meet the needs of
burned children regardless of where they live in the world.
http://snow.he.net/~cburn1/mission.php3

Burn Survivors Throughout the World Group.
This is an international non-profit organisation that gives peer
support, has emergency staff on call, articles, education, stories,
weekly chats, poems, newsletters and more.
http://www.burnsurvivorsttw.org/
Weekly chat schedule.
http://www.burnsurvivorsttw.org/chatsworldclock.html

Burn Groups Database
A database of burns support groups throught the world.
http://www.burnsupportgroupsdatabase.com/database/english.htm

Burn Survivors Network.
The Burn Survivors Network was established by a group of survivors and
carers after realising the great need for ongoing support for those
effected by burn injuries. It endeavours to facilitate communication,
understanding and emotional adjustment by means of sharing strength
and information. The aim is quality of life ?beyond survival?.
http://www.burnsurvivors.com.au/introduction.html

Australia
http://www.burnsupportgroupsdatabase.com/files/australi.htm


-------------------------------------------------------
Techniques for pain management.
There are a number of techniques that can be used including virtual
reality, hypnosis, mental imagery, distraction, biofeedback and
parental participation in care.

An overview of pain control in children.
http://healthlink.mcw.edu/article/965939384.html
Helping Your Child with Pain Control.
http://www.vh.org/pediatric/patient/pediatrics/paincontrol/



-------------------------------------------------------
Virtual reality.

Research carried out by Dr David Patterson at University of Washington
School of Medicine found that the use of virtual reality helped to
reduce pain in burn patients. When painful procedures were carried out
patients were taken into a virtual reality computer world where they
could interact with computer environment. The same technique has been
widely adopted in dental surgeries for distracting children whilst
they are treated.

Mind over Matter ? Virtual Reality and Pain Control.
http://www.washington.edu/alumni/columns/dec96/fires5.html

This site outlines the research carried out.
http://www.hitl.washington.edu/projects/burn/

Full details of the study.
http://216.239.59.104/search?q=cache:3FwHnuVG-sgJ:www.hitl.washington.edu/projects/burn/multiplepain.doc+%22coping+with+pain%22+techniques+children+burns&hl=en&ie=UTF-8



------------------------------------------------------------
Hypnosis
Hypnosis has been proved to be an effective against pain. Hypnosis
induces an altered state of consciousness to focus the child?s
attention. Hypnosis can be a better solution than breathing or
counting as it better captures a child?s short attention span.
The UW Burn Center has researched its use for burn patients. A
majority of patients were found to show some improvement.
http://www.washington.edu/alumni/columns/dec96/fires3.html



-------------------------------------------------------------
Biofeedback.
Biofeedback uses instruments to detect and amplify specific physical
states in the body. The patient is then encouraged to help bring them
under control. It reduces pain by causing relaxation. It is carried
out by trained instructors using specialised equipment.
http://www.aapb.org/public/articles/details.cfm?id=7

What is biofeedback.
http://www.aapb.org/public/articles/details.cfm?id=4


------------------------------------------------------------
Mental imagery.
The methods currently being used of mental imagery are recommended in
this article. Younger children benefit from patterned, shallow
breathing using mental images, such as a train.
http://healthlink.mcw.edu/article/965939384.html

What is mental imagery.
http://www.healthyroads.com/myhealth/content/mindbody/articles/art_FAQGuidedImagery.asp

-----------------------------------------------------------
Distraction.
Research has shown that distraction is effective in reducing a child?s
distress and pain. Distraction techniques including singing, music,
story telling, pop-up books, blowing bubbles, kaleidoscope, playing
with toys.
http://www.nursing.uiowa.edu/sites/PedsPain/Nonpharm/distrat.htm

Research that backs this up showed that watching a movie, talking
about the movie and other distractions helped to reduce distress and
anxiety. This site outlines the research carried out. It has also been
successfully repeated with infants.
http://www.significantdifference.org/cohen.html

Parental participation in care has also shown to be beneficial.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9274231&dopt=Abstract

-------------------------------------------------------
Reducing anxiety.

Anxiety can be reduced by informing the child what is happening.
Toddlers understand every day words even though they may not repeat
them. So simple and repeated explanations of what is happening will be
understood. Providing reassurance and comfort are important. They will
meet doctors , nurses and other staff who are unfamiliar to them. It
is therefore necessary to let them know who these people are and that
they are there to help them get better.

It is also important for the parents to be upbeat and not show any
anxiety as children are quick to pick up on facial messages.
http://toddlerstoday.com/resources/articles/minimizepain.htm

Medical play.
Medical play is a technique to help children to understand what is
happening to them. A doll or stuffed toy is used to explain medical
procedures.
http://www.dukehealth.org/childrens_services/medical_play.asp

---------------------------------------------------
Burn survivors stories.

Zubaidas story.
This nine year old girl was so badly burned that her chin fused to her
neck and the flesh on her upper arms had melted, fusing them to her
chest. She has undergone 12 operations of reconstructive surgery and
has made an amazing recovery.
http://snow.he.net/~cburn1/Zubaida.php3

Personal stories.
This site has 6 personal stories.
http://www.burnsurvivors.com.au/personal-stories.html

This site has a lot of stories from burn survivors.
http://www.burnsurvivorsonline.com/stories/

Burn survivor profiles.
This site has 789 profiles. You need to be a member to view them.
http://www.burnsurvivorsonline.com/NewProfiles/ViewProfiles.asp


To Laugh or Cry? ? the story of Allan Lynchuk who endured surgery to
reconstruct his face and had fingers amputated.
http://www.icbc.com/Library/recovery/Volume7/Number1/ToLaughOrCry/

Road to recovery ? Gina Gauvin?s story.
She received burns to 70% of her body, lost her right arm and the
fingers on her left arm.
http://www.projo.com/extra/2003/stationfire/gauvin/day3.html

The Long Road Home
The stories of soldiers injured in the Iraq war.
http://www.cbsnews.com/stories/2003/12/01/60II/printable586138.shtml

This site has several personal stories.
http://www.survivingburns.org/NFtestimon1.html



---------------------------------------------------
<Additional links:>

<Non-pharmacological pain management therapies for children.>
<http://www.medformation.com/ac/mm_qdis.nsf/qd/nd0367g.htm>

<Video>
<http://www.fanlight.com/catalog/films/277_nfnt.shtml>

<Pain pain go away.>
<http://um-jmh.org/HealthLibrary/Children/Child_Pain_Control.html>




<Search strategy.>

<burns "support group">
<://www.google.com/search?sourceid=navclient&q=burns+%22support+group%22>

<"mental imagery" pain>
<://www.google.com/search?hl=en&lr=&ie=ISO-8859-1&q=%22mental+imagery%22+pain>

<"parental participation" pain>
<://www.google.com/search?hl=en&lr=&ie=ISO-8859-1&q=%22parental+participation%22+pain>

<hypnosis children burns>
<://www.google.com/search?q=hypnosis+children+burns&hl=en&lr=&ie=UTF-8&start=10&sa=N>

<toddlers pain distraction>
<://www.google.com/search?sourceid=navclient&q=toddlers+pain+distraction>




<Hope this helps.>
jo64-ga rated this answer:5 out of 5 stars
Dear Belindalevez, thanks so much for such a thorough answer, this has
given us much to think about and most importantly many ideas for Caro
and Ron, (Sophies parents) to start working on. i also really
appreciate the additional comments from Crabcakes and Savario, it has
been really lovely to get such support from people unknown! we will
work our way though the web sites, so much of the information looks
hopeful, it is a really positive support when Sophie is still so much
at risk. i will also pass on this information to Molly's parents,
Molly was the other little toddler trapped under the car, she
sustained burns to 405 of her body and is at the same hospital, i am
sure her parents will also find the information valuable, again,
thanks very much, Regards Jo

Comments  
Subject: Re: help for a mother to support her 2 yo daughter cope with 80% burns to her body
From: crabcakes-ga on 03 Jan 2004 09:25 PST
 
Hi jo64,

Many of us in the Google Researcher community have been touched by the
events you have described in your question. I send my thoughts and
prayers to Sophie and her family. How we wish we could do more! I have
called the Shriner?s Hospitals and left a request for information. The
Shriner?s give excellent free care to any burn patient, in the US,
Canada and Mexico, and are the gold standard for burn management.

I am not your researcher, but as a health care worker who has seen
more than I should of this kind of tragedy, I felt compelled to send
you information as well. There is an enormous amount of information in
your answer, and in comments, and it will no doubt take a lot of time
to wade through it all. My hope is that you find at least one item to
be helpful in alleviating this child's pain and discomfort, as well as
support for the family and friends!
I hope my comment can be of some help to you in addition to
belindlevez-ga?s work. Some of what I post may duplicate what you
already have, and for this I apologise.



This brief discusses the results of a Shriner?s Hospital Study: ?Study
shows majority of children who survive massive burns can expect
favorable quality of life An extensive, long-term study by researchers
at the Shriners Hospital in Boston, published in the Journal of the
American Medical Association, shows that most children who survive
massive burns, i.e. burns involving more than 70 percent of their
bodies, can expect to have a quality of life comparable to children
their ages in the general population.?
http://www.burnsurvivor.com/resources_articles_bostonshriners.html

Artificial Skin: 
http://www.burnsurvivor.com/resources_articles_artificialskin.html

Cultured skin:
http://www.burnsurvivor.com/resources_articles_culturedskin.html

Vitro-gro, spray on ?skin? tissue generator
http://www.giveblood.redcross.org.au/DisplayNewsArticle.asp?ArticleID=31

Tissue Regeneration
http://www.lifecell.com/about/science.cfm

Burn physiology and management
http://www.emedicine.com/med/topic3401.htm


Burn Relief products
http://www.otwo.com/pdf/Burn%20ReliefKits%20&%20Accessories.pdf

Mederma for scars (Great stuff)
http://www.mederma.com/



Pain Management
http://www.burnsurvivorsttw.org/articles/painburns.html


Custom made pressure garments for burn patients
http://www.bio-con.com/


Gottfried Medical  Burn Garments
http://www.gottfriedmedical.com/access.public/burn.garments/

Shriner?s is making face masks for children, to reduce scar height and
to keep the skin supple.
http://www.shrinershq.org/whatsnewarch/archives01/military4-01.html



Nutritional Support
http://www.novartisnutrition.com/us/articleDetail?id=15&requestingPage=Product%20Summary

http://www.burnsurvivorsttw.org/nutrition/begining.html

http://www.ohsuhealth.com/dch/health/burns/nutrition.asp

http://www.musckids.com/health_library/burns/nutrition.htm



Bedding
http://www.medbc.com/annals/review/vol_2/num_3/text/vol2n3p140.htm

Hover Mat (The videos were poor) Click on ?Brochure? to see pictures 
http://www.hovermatt.com/demonstration_video.html



Returning Home
http://www.ohsuhealth.com/dch/health/burns/home_comming.asp

http://www.ohsuhealth.com/dch/health/burns/coping.asp

http://www.ohsuhealth.com/dch/health/burns/home_care.asp


Preventing Contractures ? VERY important
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/burns/retscar.html

http://www.musckids.com/health_library/burns/retscar.htm
http://www.emedicine.com/plastic/topic155.htm

http://wo-pub2.med.cornell.edu/cgi-bin/WebObjects/PublicPediatrics.woa/14/wa/viewContent?contentID=1754

http://www.ohsuhealth.com/dch/health/burns/prevent_scars.asp



Suggestions for helping a patient and family
http://www.benjaminjones.org/kedwards_art.htm


Recommended Books on coping with burns:
http://www.burnsurvivor.com/books.html


The Phoenix Society for Burn Survivors. This page is written in
frames, so I can?t give you a link to each article. Click on ?Family
Resources? , in teal, in the left hand column. There you will find
several brochures on topics such as  Helping Children Understand and
Cope with Hospitalization ,  Reclaiming Life, Handling Teasing, When
People Star, Surviving Against All Odds. These are in .pdf format and
may take a bit of time to open. I think they are worth it. Burn
Support News publishes a quarterly newsletter to which you can
subscribe for free, via e-mail , found also on the column to the left.
http://www.phoenix-society.org/


Burn Survivors Throughout the World Organization
http://www.burnsurvivorsttw.org/home.html



Not yet built, but could be considered as a future resource, Royal
Perth Hospital is building the Telstra Centre for Burns Reconstruction
and Rehabilitation.
http://www.wa.alp.org.au/media/1203/20001350.html
http://www.rph.wa.gov.au/rph.html


Additional miscellaneous information:


Pediatric Pain Management. This site has a copy of the useful
pediatric Happy-Sad face pain scale.
http://www.co.alameda.ca.us/PublicHealth/organization/divisions/ems/Resource_policy_manual/pain_management_peds.pdf
and
The Suffering Child
http://www.thesufferingchild.net/congress/21.htm

GreenFingers
http://www.greenfingerslandscaping.com/wounds/html/burns.html

University of Iowa
http://www.nursing.uiowa.edu/sites/PedsPain/GenePain/Burns.htm

Wound care, nutrition, dressing changes, terminology, medications, etc.
http://www.woundtowellness.com/hcguidelines.PDF


Patient Success Stories
http://www.shrinershq.org/patients/index.html

Pediatric Prosthesis
http://www.oandp.org/jpo/library/1992_04_196.asp

After Recuperation, Burn Camps
http://www.phoenix-society.org/

Best wishes for a rapid recovery for Sophie!
Sincerely,
crabcakes-ga


I am still waiting for the Shriners to return my call. In my message I
mentioned that if they were *unable* to help, they did not need to
waste a call. It may be that they are closed untill Monday. I will
post any additional information that I get.
Subject: Re: help for a mother to support her 2 yo daughter cope with 80% burns to her body
From: saverio-ga on 04 Jan 2004 07:40 PST
 
Selected Nutritional/Alternative Medicine Approaches for burn victims.
 I?ll look for more options and post at another time.  These will
help, please consider using them.

If you are interested in specifics regarding any of these approaches I
suggest you find a licensed Naturopathic physician to help you.  You
can find one by going to www.naturopathic.org.  You can also check out
www.connecticutcenterforhealth.com to learn more about Naturopathic
medicine.

These approaches are based on the notion that if you increase healing
of the skin the pain will subside to some degree.

As controversial as it is an option to consider is the use of medical
marijuana.  Medical use of marijuana in this case will probably bring
about some pain relief and ease anxiety.  You?ll have to obtain a
source.  I suggest putting it into food.  I cannot advise you as to
dose.  You?ll have to experiment starting with small amounts and
working your way up.

I would also try homeopathic therapy.  It is simple, easy and cheap to
use.  You?ll have to find an experienced homeopathic practitioner in
your area to prescribe the appropriate remedies.

Nutritional
Omega-3 Fatty Acids ? Specifically fish oil and to a lesser extent flax oil
In experimental work with animals, researchers were able to show that
the omega-3 fatty acids had an important influence on outcome
variables following severe burn injury. Dietary fatty acids alter
phospholipid composition of cell membranes and the quantity and types
of prostaglandins that are synthesized. Improving the ratio of omega-3
to omega-6 fatty acids enhances immune function and reduces
inflammation.(22)
L-Glutamine ? an amino acid
Sever injury, such as burns, cause plasma glutamine levels to decline
substantially. In one study, patients with major burn injuries, the
plasma glutamine concentration was 58% lower than that in normal
controls and it remained low for at least 21 days after the injury.
These findings indicate that the decrease in plasma glutamine
concentration may contribute to the injury-induced impairment of
immune function occurring after major burn injury.(23) Glutamine
increases nitrogen retention, helps preserve skeletal muscle mass,
reduces the incidence of wound and general infections, and shortens
hospital stays in patients suffering from burns.(24)
Arginine ? an amino acid
Results from animal studies indicate that arginine supplementation
decreases the mRNA expression of inflammatory cytokines in organs and
improves the survival rate after thermal injury.(25)
The recoveries of burn patients receiving 2% of energy supplied by
arginine were compared to similar burn patients who did not receive
arginine. Arginine was found to significantly enhance the T lymphocyte
response to phytohemagglutinin, CD4 phenotype expression, CD4/CD8
ratio, IL-2 production and IL-2 receptor expression, as compared with
the control group. These improvements prompted researchers to suggest
that arginine should become one of the most important nutrients
supplied to burn patients.(26)
Vitamin C
Thirty-seven patients with burns over more than 30% of their total
body surface area, hospitalized within 2 hours after injury, were
randomly divided into ascorbic acid and control groups. The results of
this prospective, randomized study were significantly reduced
resuscitation fluid volume requirements, body weight gain, and wound
edema after adjuvant administration of high-dose ascorbic acid (66
mg/kg per hour) during the first 24 hours following thermal injury.
There was also a reduction in the severity of respiratory dysfunction
in these patients.(27)
Ascorbic acid has also been used topically in combination with other
substances as a safe and effective method of improving repair and
controlling infection of wounds. The protocol consists of daily
debridement and a topically, balanced solution consisting of salts,
amino acids, a high-molecular weight D-glucose polysaccharide, and
ascorbic acid. Wounds treated with this solution were second- and
third-degree thermal burns, diabetic lesions, decubitus, varicose and
stasis ulcers. The majority of cases responded quickly and local
infection was controlled early. In 4 to 8 weeks, small- and
medium-sized lesions were healed.(28)
Vitamin E
The bodies of patients who have been severely burned undergo a
substantial increase in oxidative free radical damage. In one study,
serum vitamin E levels decreased most significantly from days 6 to 8
postburn in burn patients, while serum lipid peroxides increased
significantly. In burn patients who received vitamin E, serum vitamin
E levels increased and lipid peroxides decreased to the levels of
healthy people. These results suggest that providing burn patients
with supplemental vitamin E may provide substantial benefit.(29)
However, several studies report that topical application of vitamin E
to burns is ineffective and in some cases may actually be
detrimental.(30, 31)
Zinc
Zinc has a long history as an agent used to promote wound healing. It
was used topically as calamine lotion as far back as 1500 BC by the
Egyptians. There are over 200 zinc requiring enzymes in the body. For
example, DNA polymerase is required for cellular proliferation during
healing, and zinc-containing superoxide dismutase is an important
anti-oxidant enzyme. During an infection, leukocytes produce free
radicals to kill bacteria. Zn-SOD is an important part of our immune
system, which protects our body from damage while free radicals are
being produced to fight an infection.(32)
Stress from events such as burns, surgery, or other accidental injury,
causes serum zinc levels to decline.(33) One explanation for the fall
in serum zinc levels during wound healing is because zinc is mobilized
to the trauma site. Zinc concentrates in wounds during the period of
collagen synthesis and affects the strength of new tissue. It is
thought that this is why topical administration of zinc improves wound
healing, even in patients who are not zinc deficient.(34) Topical
administration of zinc chloride (spray or ointment) reduces the size
of the wound and shortens healing time.(35)
In zinc deficiency, there is delayed closure of wounds and ulcers and
the collagen produced during zinc deficiency has weaker tensile
strength.(36) Zinc deficiency also compromises the immune system in
several ways. It causes a decrease in the number of lymphocytes and
natural killer T-cells, and a decrease in the size of the thymus,
resulting in an increased susceptibility to recurring infections and
poor wound healing.(37)
Honey
Honey dressings are reported to be an effective treatment for burns.
Honey's high viscosity enables it to form a physical barrier, which
prevents bacterial colonization and reduces the incidence of
infections in wounds. The antibacterial effects are reportedly due to
hydrogen peroxide, which is produced due to the action of the enzyme
glucose oxidase secreted by the bees. The viscous barrier formed by
honey creates a moist environment, which helps quicken wound healing.
Nutrients in honey, such as levulose and fructose, improve the local
nutrition and promote epithelialization.(38)
 
Herbal
Aloe Vera
Aloe, a genus with over 150 species, is mostly native to East and
South Africa. Aloe is a succulent plant that has been used medicinally
for centuries. Records of its use date back to 1750 BC. Aloe vera (a
synonym for Aloe species) leaf gel has been used for centuries as a
topical wound healing agent for traumatic wounds (from mechanical,
traumatic, or thermal injury, including contusions, abrasions,
punctures, fractures, sunburn, burns, and frost bite), and chronic
wounds (including pressure and diabetic ulcers).(39) In one study, it
was observed that aloe increased the collagen content of granulation
tissue as well as cross-linking as seen by increased aldehyde content
and decreased acid solubility.(40) The type I/ type III collagen ratio
of treated groups was lower than that of the untreated controls,
indicating enhanced levels of type III collagen.
The influence of aloe on the glycosaminoglycan (GAG) components of the
matrix in a healing wound has also been reported as a mechanism in
wound healing. The early stage of wound healing is characterized by
the deposit of a provisional matrix, followed by the formation of
granulation tissue and synthesis of collagen and elastin. A recent
study reported the influence of aloe vera on the content of GAG and
its types in the granulation tissue of healing wounds.(41) The amount
of ground substance synthesized was found to be higher in wounds
treated with aloe vera gel, with the levels of reported
glycohydrolases (hyaluronic acid and dermatan sulfate) being elevated,
indicating increased turnover of the matrix. Both topical and oral
treatments with aloe vera were found to have a positive influence on
the synthesis of GAGs and contribute to wound healing. An amorphous
hydrogel dressing derived from the aloe plant containing acemannan is
approved by the FDA for the management of stages I through IV pressure
ulcers.(42)
Aloe contains vitamins and minerals (including vitamin C, E, and zinc)
reported to be beneficial in wound healing.(43, 44)
Aloe vera has been reported for years to be effective in treating
various types of burns.(45, 46) A recent study supported these
findings, where aloe vera gel was reported to increase
microcirculation to the burn area, causing vasodilation and increased
post-capillary venular permeability.(47) There has been a report of
aloe hindering the wound healing process, causing a thickness of
granulation tissue with a decreased amount of hair follicles as
compared to 1% silver sulfadiazine cream.(48)
Aloe vera gel also reportedly aids in wound healing topically due its
anti-inflammatory activity.(49) Aloe constituents with
anti-inflammatory activity include: mannose-6-phosphate;(50, 51) the
glycoproteins aloctin A and alprogen;(52, 53) a C-glucosyl
chromone;(54) the anthraquinones;(55) and gibberellin.(56)
St. John's Wort
St. John's wort has gained a great deal of attention for its use in
minor depression. St. John's wort also has traditional uses in the
topical treatment of superficial wounds, burns and dermatitis. In a
study, an ointment containing an extract of hypericum was compared
with untreated skin in inflammatory conditions of the skin such as
wounds and burns.(57) Treatment with the hypericum ointment resulted
in a significant suppression of the mixed epidermal cell lymphocyte
reaction MECLR and also of the proliferation of T lymphocytes. These
results may provide a rationale for the traditional treatment of
inflammatory skin disorders with topical hypericum extracts.
Another study evaluated the wound healing potential of a hypericum
ointment applied to wounds of laboratory animals.(58) The effect
produced by the extract ointment, in terms of wound contracting
ability, wound closure time, regeneration of tissues at wound site,
tensile strength of the wound and histopathological characteristics
were comparable to those of nitrofurazone ointment.
Calendula
Used since ancient times as a healing agent, calendula is mentioned in
herbal books that date back to 1373. The name calendula refers to the
plant's tendency to bloom in accordance with the calendar ? every
month in some regions of the Mediterranean, or during the new moon.
Used historically as "poor man's saffron", calendula was used both as
a culinary herb and spice as well as a medicinal agent. Extracts of
calendula flowers are popular in Europe where they are employed in
various first aid creams and cosmetics. Calendula is a very popular
homeopathic remedy also, used topically for skin problems including
diaper rash and other conditions in children and infants.(59)
Calendula is listed in the German Commission E Monographs for use as a
mouthwash for the oral and pharyngeal mucosa as well as topically for
the skin.(60)
Calendula extracts have been used topically to promote wound healing,
with several studies reporting a measurable effect. In a laboratory
study, an ointment containing a 5% fractionated extract of calendula
flowers markedly stimulated the physiological regeneration and
epithelialization of wound tissue, reported to be due to more
intensive metabolism of glycoproteins, nucleoproteins and collagen
proteins during the regenerative period in the tissues.(61) Another
later study reported immune activation by calendula extracts using in
vitro granulocyte tests and in vivo carbon clearance tests, both
laboratory determinants of immune activation.(62) Calendula extracts
have also been reported to be anti-inflammatory, which also aids in
wound repair and healing.(63, 64) The anti-inflammatory effect has
been reported to be due to the triterpenoids (specifically faradiol)
found in calendula.(65) Various case reports of calendula preparations
healing wounds, including traumatic wounds and chronic wounds
(including pressure sores and diabetic ulcers).(66)
Gotu Kola
Gotu kola is reported to have a positive effect on tissues,
specifically skin, connective tissue, lymph and mucous membranes.(67,
68, 69) It does not contain any caffeine and is not related in any way
to kola nut. Gotu kola has been used primarily for venous
insufficiency, soft tissue inflammation and infection and for
postsurgical wound healing.(70, 71) Asiaticosides are reported to
exert a preferential stimulation of collagen synthesis, in addition to
stimulating glycosaminoglycan synthesis.(72) Also, gotu kola's affects
the connective tissue by strengthening weakened veins.(73) Gotu kola
may assist in the maintenance of connective tissue. In the treatment
of scleroderma, gotu kola may also assist in stabilizing connective
tissue growth, reducing its formation.(69) It reportedly stimulates
the formation of hyaluronidase and chondroitin sulfate, as well as
exerting a balancing effect on the connective tissue.(74) It is
believed to have an effect on keratinization, which aids in thickening
skin in areas of infection.(75) Gotu kola is used topically and
internally for skin conditions including psoriasis and eczema.(76)
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46 Rodriquez-Bigas M, et al. Comparative evaluation of aloe vera in
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47 Somboonwong J, et al. Therapeutic effects of Aloe vera on cutaneous
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48 Kaufman T, et al. Aloe vera gel hindered wound healing of
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49 Reynolds T, et al. Aloe vera leaf gel: a review update. J
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50 Davis RH, et al. Anti-inflammatory and wound healing activity of a
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51 Vazquez B, et al. Antiinflammatory activity of extracts from Aloe
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52 Saito H, et al. Pharmacological studies on a plant lectin aloctin
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53 Ro JY, et al. Inhibitory mechanism of aloe single component
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54 Hutter JA, et al. Antiinflammatory C-glucosyl chromone from Aloe
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55 Davis RH, et al. Anti-inflammatory activity of Aloe vera against a
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56 Davis RH, et al. Aloe vera and gibberellin. Anti-inflammatory
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57 Schempp CM, et al. Topical Application of St John's wort (Hypericum
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58 Mukherjee PK, et al. Evaluation of In-Vivo Wound Healing Activity
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