Healing activity of Stryphnodendron adstringens (Mart.), a Brazilian tannin-rich species: A review of the literature and a case series

Abstract Introduction Stryphnodendron adstringens, commonly known as “barbatimao”, is a Brazilian savannah plant that has been long used in folk medicine due to its wound healing properties. However, there is a lack of integrated analyses of its healing activity based on scientific evidence. Methods The present study provides a literature review based on articles published in journals indexed in PUBMED and SCIELO databases. Moreover, a case series of four patients treated with a commercial barbatimao bark extract ointment is described. Results and Discussion Forty-two publications on barbatimao were included in this review, most of which were published in English. From these studies, several biological and clinical actions of barbatimao were identified including anti-inflammatory, antioxidant, anti-ulcer, antimicrobial, and anti-parasitic effects, in addition to healing properties. The healing ability of barbatimao is scientifically described using evidence mainly obtained from animal experimental studies, and only one clinical trial exists that describes its healing effect on decubitus ulcers. Therefore, it was considered relevant to report a case series of patients subjected to barbatimao treatment for wounds caused by intense involuntary physical trauma (external accidents) or surgery. Considering all cases, the complete wound healing duration was 3.6 ± 0.8 months. Barbatimao is a tannin-rich plant, and chemical matrix analysis suggests that its wound healing effect is mainly due to high levels of epigallocatechin-gallate (EGCG) and gallic acid molecules. Conclusion Considering the difficulty in treating chronic or extensive wounds, barbatimao could be an effective, low-cost phytotherapy formulation with low levels of toxicity.