# The Effects of _Anthyllis vulneraria_ Hydroalcoholic Leaf Extract as an Adjuvant in Wound Healing
## 1 Introduction  
The study of the effect of _Anthyllis vulneraria_ is a very important area of research. The study of the effect of _Anthyllis vulneraria_ is a very important area of research. ## 1 Introduction  
Recent years have seen an increased interest in finding and exploiting the anti-inflammatory, anti-microbial, and anti-oxidative properties of medicinal plants as alternatives to synthetic compounds. Naturally occurring substances, such as phenolic components, proteins, minerals, and vitamins, found in both the leaves and infloresances of plants, are becoming attractive to the pharmaceutical, cosmetic, and food industries [1,2]. Natural compounds, particularly polyphenols and flavonoids, have been extensively documented through both in vitro and in vivo studies and have been shown to exhibit a range of beneficial biochemical activities, including anti-inflammatory, antitumoral, immunomododulatory, wound healing, and anti-aging effects. Their popularity has increased over the past few years as they have become attractive therapies for debilitating diseases such as cardiac, metabolic, neurodegenerative, hepatic, and dermatological diseases [3, 4, 5, 6, 7]. A burn is a generic term, indicating a skin or other tissue injury caused by exposure to heat, chemicals, friction, radiation, or electricity [8]. Burn injuries pose a major contemporary health problem, both because of their economic burden, as well as their effect on the quality of life of patients. They are amongst the most frequent forms of wounds and a primary cause for hospital presentation. Every year, countless patients acquire and suffer from different forms of such afflictions, which increase their overall mortality and morbidity, while also affecting and overloading the health system [9]. It is estimated by the WHO that more than 180 000 people die annually from burn or burn-related injuries, while the survivors face prolonged hospitalization, infections, as well as chronic complications such as disfigurement, disability, or stigmatization [10]. Burn pathophysiology and healing are complex processes that involve multiple cellular and molecular mechanisms in three phases: inflammation, proliferation, and remodeling. Each phase must be correctly carried out to ensure proper healing and to avoid acute or chronic complications [11]. The inflammatory phase is characterized by vasodilatation and a cascade of inflammatory factors. In the first 1-5 days post injury, neutrophils, monocytes, and macrophages are chemoactively attracted to the wounded site and secrete proinflammatory mediators and free oxygen radicals [11]. The increased quantity of substances, like oxygen radical species, in parallel with decreased quantities of antioxidant enzymes, easily create an imbalance in oxidative stress [1]. Therefore, substances that can tip the balance towards an anti-inflammatory response could help to reduce the negative effects of inflammation, providing a better environment for both molecular and structural healing [8]. The proliferative phase is characterized by the processes of angiogenesis, collagen formation and deposition, epithelization and wound contraction, which usually starts on the 3 th or 4 th day [8,12]. In the case of superficial burns, healing starts from the still-present epithelial structures, such as hair follicles, and it usually resolves without scarring. For deep burns, as the epithelial adjacent structures are destroyed, healing requires the migration of keratinocytes from the surrounding healthy skin, as well as the contraction of the wound site, carried out by fibroblasts, and usually leads to scarring [8,11]. Finally, the remodeling phase usually starts after 3-4 weeks, and, depending on the wound's severity, can last for years. The key cell player in this phase is the fibroblast. Temporary structures are destroyed and replaced with permanent structures like collagen type 1. The disruption of this phase leads to scar formation or chronic wounds [8,13].