Birchin'

Birchin'

“There is really no such thing as alternative medicine, just medicine that works and medicine that doesn’t.”

So much of the alternative medicine world can be almost be dismissed out of hand on the basis of prior plausibility. Rieki, Homeopathy, Reflexology, Chromatotherapy are not based on reality and should not have any effect once bias is removed. Other interventions are simply forms of exercise that are called alternative medicine, like tai-chi.

There is one intervention that is neither intrinsically ludicrous nor a rebranding of a standard practices:  botanicals. While the provenance as to why a given botanical is recommended for a given problem can be sketchy, plants often have valuable and effective chemicals to fight many diseases and improve life. Like coffee and caffeine.

Wound care and chronic wounds are an ongoing problem in medicine and there are TNTC preparations touted to improve wound healing. I have no clue what is the best way to care for wounds except to follow the advice of my plastic surgeon attending years ago who advised 'never put in a wound what you wouldn’t put in your eye'. So I cover all my wounds with soft contact lenses. I am always on the look out for better ways to heal wounds, so I was intrigued by From a Traditional Medicinal Plant to a Rational Drug: Understanding the Clinically Proven Wound Healing Efficacy of Birch Bark Extract. I especially liked the slight snarkyness, but maybe that’s just me.

The basis of study is pretty thin: an argument from antiquity, a few case reports and one small but evidently impressive, clinical trial:

The descriptive comparison is demonstrating quite a remarkable advantage of the ointment versus the moist wound dressing in promoting wound healing: even having in mind the small number of 24 patients within the protocol, the superiority of aesthetic benefit by triterpene treatment after 14 days (22 out of 24 patients), after 3 month (15 out of 19 patients) and after 1 year (8 out of 10 patients) is obvious.

Well, not obvious to me as the pictures are behind a paywall.

The article is way above my level of understanding for the basic science of wound healing, but it would appear that birch bark extract has a salubrious effect on wound healing by a variety of mechanisms.

Taken together, we assume that TE and betulin enhance the beginning of the inflammatory phase of wound healing by a transient upregulation of pro-inflammatory mediators, which does not result in a prolonged inflammation. Furthermore, our studies provide evidence that birch bark extract influences the second stage of wound healing, the new tissue formation phase, by increasing cell migration of primary human keratinocytes shown in a scratch assay experiment.

The clinical and basic science of birch bark extract is preliminary and I hope it pans out. I certainly agree with their conclusion

identify birch bark as the first medical plant with a high potential to improve wound healing, a field which urgently needs effective remedies.

Unlike most of the pseudo-medicines discussed at this site, birch bark extract may not only be effective, but be effective within out understanding of science-based medicine.  And I predict a flurry of hype pushing the product.

References

J Craniomaxillofac Surg. 2012 Jul;40(5):e150–4. doi: 10.1016/j.jcms.2011.07.020. Epub 2011 Aug 26. Accelerating the aesthetic benefit of wound healing by triterpene. http://www.ncbi.nlm.nih.gov/pubmed/21872485

From a Traditional Medicinal Plant to a Rational Drug: Understanding the Clinically Proven Wound Healing Efficacy of Birch Bark Extract Published: January 22, 2014DOI: 10.1371/journal.pone.0086147 http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0086147;jsessionid=949C173D5E622800FF6AF4DE3F769F11

Good News of a Sort
Points of Interest: 2/5/2014

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