Mechanism-Based Evaluation of Medicinal Plants in the Management of Venous Leg Ulcers: A Comparative Review

Venous leg ulcers (VLUs) are chronic, slow-healing wounds primarily caused by chronic venous insufficiency, venous hypertension, inflammation, oxidative stress, impaired angiogenesis, and defective collagen remodelling. They represent a significant clinical burden due to prolonged healing time, high recurrence rates, and negative impact on patient quality of life. Conventional management strategies such as compression therapy, wound dressings, and antimicrobial treatment are effective but often require long treatment durations and may not adequately address the underlying pathological mechanisms. In recent years, medicinal plants have gained attention as complementary therapies because of their multi-targeted actions, cost-effectiveness, and favourable safety profiles. This review focuses on the therapeutic potential of three medicinal plants—Centella asiatica, Hibiscus rosa-sinensis, and Mimosa tenuiflora—in the management of venous leg ulcers. These plants exhibit diverse pharmacological activities, including anti-inflammatory, antioxidant, angiogenic, collagenstimulating, and antimicrobial effects, which directly counteract the key pathophysiological processes involved in VLUs. Among them, Centella asiatica demonstrates the most comprehensive wound-healing profile, supported by experimental and clinical evidence showing enhanced collagen synthesis, improved microcirculation, angiogenesis, and reducedinflammation. Hibiscus rosa-sinensis primarily contributes anti-inflammatory and antioxidant support, while Mimosa tenuiflora is particularly beneficial for infected and biofilm-associated ulcers due to its strong antimicrobial activity. Overall, medicinal plants represent promising adjuncts to conventional therapy for venous leg ulcers. However, further well-designed clinical trials, standardised formulations, and long-term safety evaluations are necessary to establish their definitive role in clinical practice.