Plant-derived modulators of the hemostasis-wound healing axis: mechanisms, evidence, and translational potential

Medicinal plants are widely used to control bleeding and support wound care, but the hemostatic and reparative evidence attributed to a species often derives from different plant parts, extracts, or formulations. This critical narrative review examines the ethnomedicinal, experimental, clinical, safety, and translational evidence for plant-derived preparations reported to modulate one or more stages of the hemostasis-wound-healing axis. Structured searches of PubMed/MEDLINE, Scopus, and Web of Science were updated through 19 July 2026 using terms related to medicinal plants, coagulation, platelet function, wound healing, formulation, standardization, toxicity, and safety. The literature retained for detailed synthesis encompassed crude extracts, enriched fractions, latex-derived proteases, isolated plant metabolites, hydrogels, nanoparticles, and other formulated materials. Mechanistically, direct evidence was concentrated primarily in fibrinogen-cleaving plant proteases and notoginsenoside Ft1-mediated platelet signaling. In contrast, anti-inflammatory, pro-angiogenic, antimicrobial, and extracellular-matrix-related effects were supported mainly at the extract, fraction, or formulation level. The strength and mechanistic depth of the evidence varied substantially among species, preparations, experimental models, and outcomes, and hemostatic and wound-repair effects were frequently demonstrated using different materials from the same species. Thus, the available evidence supports the hemostasis-wound-healing axis as a useful framework for prioritizing candidates, but current evidence does not support medicinal plants as a uniformly effective therapeutic class. Translation should initially prioritize chemically and biologically standardized topical or locally retained products, component-specific controls, clinically relevant preclinical models, exposure-response and safety characterization, and adequately powered indication-specific trials. Taxonomic validity, material traceability, sustainable sourcing, and ethical governance of traditional knowledge should be integrated from the outset.