Efficacy of Rhizophora mangle cream in venous ulcer: a randomized controlled clinical trial

Compression therapy is the primary treatment for venous ulcers (VU). Topical treatments are used as an adjunct to accelerate healing, but they can be costly, and there is currently no standard medication.

To evaluate reduction in venous ulcer area in patients treated with 5% aqueous extract of Rhizophora mangle L. leaves in cream form.

Patients were randomized into 2 groups: the experimental group (EG) (55 ulcers) received 5% Rhizophora mangle cream, and the control group (CG) (45 ulcers) received medium chain triglyceride oil. Ulcers were evaluated using the MEASURE (measurement, exudate, appearance, suffering, weakening, reassess, edge) methodology, and area was measured using software on day 1, 4 weeks, 8 weeks, and 12 weeks.

At 12 weeks, the EG showed a mean 51.69% reduction in ulcer area (mean [SD] 3.97 [6.18] cm²), whereas the CG exhibited lesion worsening, with a mean increase in ulcer area corresponding to a -187.82% variation (mean [SD], 12.17 [20.17] cm²). Complete healing was observed in 34.5% of ulcers in the EG compared with 15.6% in the CG (P = .002). Furthermore, the EG demonstrated greater improvement across all clinical ulcer parameters than the CG.

The 5% Rhizophora mangle cream was effective in venous ulcer area reduction and clinical healing, which suggests that it may be an effective an alternative treatment for venous ulcers in the lower limbs.