Clinical Effectiveness of Traditional Polyherbal Formulations for Wound Healing: A Systematic Review and...

Chronic wounds, especially in diabetic patients, are difficult to manage because of delayed healing and high infection risk. Traditional polyherbal formulations, which are composed of multiple medicinal plants with synergistic effects, are widely used in wound care, but their clinical effectiveness has not been comprehensively synthesized. This study aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effectiveness of traditional polyherbal formulations for wound healing. Databases were searched, and RCTs involving adults with wounds, where the intervention was traditional polyherbal formulation rather than a placebo, standard care, or other active treatments, were included. The meta-analysis was conducted via a random-effects model, and the certainty of evidence was evaluated via GRADE. Eight RCTs were included. The pooled mean difference for healing time favored polyherbal formulations (-3.28 days; 95%CI = -8.56 to 2.01) but was not statistically significant. Similarly, HbA1c reduction (-5.97%; 95%CI = -30.86 to 18.93) was not significantly different, with high heterogeneity (I² = 98%), and no publication bias was detected. Although several individual herbs within these formulations possess tissue-regenerative, angiogenic and anti-inflammatory properties, the pooled results indicate only a modest, nonsignificant trend toward faster healing. Variations in formulation composition, treatment duration, and methodological quality limit the certainty of evidence, which ranges from high (age) to very low (HbA1c) on the GRADE assessment. Overall, polyherbal formulations show therapeutic promise as adjuncts to standard wound, whereas larger, well-designed trials using standardized formulations and clinically relevant endpoints are needed to establish their efficacy and optimize their clinical application.