Applications of propolis-based materials in wound healing

**Background:** Propolis, a natural resinous substance collected by bees, has been used since ancient times for wound healing due to its antiseptic, antimicrobial, and anti-inflammatory properties. Despite its long history, a comprehensive review of propolis-based wound dressings was lacking. This narrative review aims to fill that gap by summarizing the wound healing process, the properties of propolis relevant to wound care, and the various formulations (e.g., hydrogels, nanofibers, films) used to create propolis-based dressings.

**Methods:** The authors conducted a narrative review of the literature, synthesizing findings from multiple studies on propolis-based materials for wound healing. They categorized the wound healing process into four stages: hemostasis, inflammation, proliferation, and remodeling. They then reviewed the biological activities of propolis (antimicrobial, antioxidant, anti-inflammatory) and how these contribute to each stage. The review also classified propolis composites by material type: textiles/nanofibers, hydrogels, natural rubber, cellulose, starch, and synthetic polymers. Tables 1–3 summarize key studies, including specific formulations (e.g., 2% propolis ointment, 0.5% propolis in cornstarch/hyaluronic acid films) and their effects.

**Key Results:** Propolis contains 50% resin (flavonoids and phenolic acids), 30% waxes, 10% essential oils, 5% pollen, and 5% other compounds. Its polyphenols inhibit reactive oxygen species (ROS), chelate metal ions, and scavenge free radicals, reducing oxidative damage. Propolis accelerates wound healing by promoting collagen type I expression, re-epithelialization, and angiogenesis. In diabetic rodent models, propolis normalized neutrophil and macrophage infiltration, preventing persistent inflammation. For burns, propolis enhanced skin cell proliferation and reduced wound area more efficiently than standard treatments. Specific formulations showed: (1) Cornstarch/hyaluronic acid films with 0.5% propolis extract exhibited higher antibacterial activity and no cytotoxicity, accelerating wound healing. (2) Propolis-loaded polyurethane nanofibers improved cell compatibility and antibacterial activity. (3) Hydrogels containing propolis (e.g., polyacrylic acid hydrogel) showed rapid wound contraction and closure in rat models. (4) Propolis nanostructured lipid carriers increased antioxidant activity by 25-fold and antimicrobial effect twofold, with faster wound closure and minimal scar formation. (5) Electrospun cellulose acetate nanofibers with propolis repaired epithelial cells, hair follicles, and sebaceous glands in burn wounds after 21 days in mice.

**Clinical Implications:** Propolis-based dressings offer a natural, biocompatible alternative to conventional wound care products like silver sulfadiazine. They are effective for various wound types, including diabetic ulcers, burns, surgical wounds, and pressure ulcers. Propolis reduces inflammation, infection risk, and scar formation while promoting faster healing. However, large-scale industrial production remains challenging due to low production rates of electrospun scaffolds. Future directions include fine-tuning biodegradation rates and developing cost-effective manufacturing methods. The review supports propolis as a promising material for advanced wound dressings, particularly for chronic wounds and burns.