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Evaluation of the Wound-healing Activity of Ethanolic Extract of Morinda citrifolia L. Leaf

Wound healing occurs in three stages: inflammation, proliferation, and remodeling. The proliferative phase is characterized by angiogenesis, collagen deposition, gran-ulation tissue formation, epithelialization and wound contraction. In angiogenesis, new blood vessels grow from endothelial cells. In fibroplasia and granulation tissue formation, fibroblasts grow and form a new, provisional extracellular matrix by excreting collagen and fibronectin. Collagen, the major component which strengthens and supports extracellular tissue, contains substantial amounts of hydroxyproline, which has been used as a biochemical marker for tissue collagen. In epithelialization, epithelial cells proliferate and spread across the wound surface. Wound contraction occurs as the myofibroblasts contract. Platelets release growth factors and other cytokines. Chronic wounds are wounds that fail to heal despite adequate and appropriate care. Such wounds are difficult and frustrating to manage. Current methods used to treat chronic wounds include debridement, irrigation, antibiotics, tissue grafts and proteolytic enzymes, which possess major drawbacks and unwanted side effects.