The efficacy of topically applied Sappan wood (Caesalpinia sappan L.) ethanol extract during incision wound healing in albino rats

Background: Medical manifestations in the form of incisions, burns, and trauma will trigger a natural wound-healing
process that involves complex interactions between cells. Brazilin and other secondary metabolites found in Sappan
wood have numerous bioactive qualities, including anti-inflammatory, anti-cancer, and antioxidant properties.
Aim: This study aimed to investigate the efficacy of Sappan wood (Caesalpinia Sappan L.) ethanol extract topically
on the incision wound healing of albino rats. Methods: Twenty male rats were randomly assigned into five groups with four replications, i.e., (C-) was treated ointment-based, (C+) was treated with 10% povidone-iodine, (T1, T2, and T3 groups) were treated with Sappan wood extract concentration for 6.5%, 15%, and 30%, respectively. The treatment was topically administered to wounded areas twice a day for 15 days. Wound healing was evaluated histologically as the following parameters collagen deposition, polymorphonuclear neutrophils (PMN), angiogenesis, and fibrosis degree using H&E staining. IL-2 level was evaluated using the enzyme-linked immunosorbent assay (ELISA) method. Wound length reduction was
calculated on days 8 and 15.

Results: As a result, the 6.5% (T1), 15% (T2), and 30% (T3) Sappan wood extract groups were improved significantly
(p < 0.05) compared to ointment-based (C-) and povidone-iodine (C+) groups on the collagen deposition, PMN, angiogenesis, fibrosis degree, and IL-2 level. In particular, the 6.5% (T1) Sappan wood extract group was highlighted significantly (p < 0.05) compared to other groups, evidenced by the improvisation of wound healing parameters and reduction of wound length on days 8 and 15.
Conclusion: In conclusion, a 6.5% Sappan wood extract revealed its applicability to improve incision wound healing
in albino rats.