Efficacy and safety of Centella asiatica in wound healing: A systematic review and meta-analysis

Centella asiatica (L.) Urb. is a medicinal herb belonging to the family Apiaceae. It is commonly known as Brahmi, Gotu kola, Ondelaga, and Indian pennywort. The plant has been extensively used in traditional systems of medicine such as Ayurveda, Traditional Chinese Medicine, and Southeast Asian folk medicine for the treatment of skin conditions, including wounds, ulcers, burns, and skin infections.

This study aimed to conduct a systematic review and meta-analysis to evaluate the wound-healing efficacy of Centella asiatica on the basis of available preclinical evidence.

This investigation was performed as per the PRISMA guidelines. Extensive examination of literature was performed across Medline/PubMed, Scopus, EMBASE, Google Scholar, and the Cochrane Library until 31 January 2025. The studies retrieved were filtered based on the set inclusion and exclusion criteria. Statistical meta-analysis was performed on quantitative data extracted from the studies that qualified for inclusion.

A total of sixteen preclinical studies were identified that satisfied the criteria for inclusion and were subsequently incorporated in the meta-analysis. However, out of the sixteen studies, five studies did not have quantifiable data thus, a total of eleven studies were analyzed. The Centella asiatica treated groups, as compared to the untreated or vehicle-treated control groups, showed a significant improvement in numerous wound-healing parameters. These parameters encompassed morphological outcomes (tensile strength, epithelization period, wound contraction efficiency, and wet and dry tissue weights), biochemical markers (hydroxyproline content, collagen deposition, and tissue protein levels), and histopathological features (neovascularization, reduced inflammation, and increased fibroblast proliferation). Furthermore, three studies evaluating acute dermal toxicity according to OECD Guideline 404 found no skin irritation or adverse effects, thus suggesting a favorable safety profile.

This systematic review and meta-analysis provide preclinical evidence to substantiate the wound-healing efficacy and safety of Centella asiatica. The evidence is indicative of its therapeutic potential for wound care, and thus, it beckons for more advanced clinical trials to ascertain its translational applicability.