Long-Term Cosmetic Benefit of Wound Healing by Betuline

Highly purified betuline as a triterpene dry extract from birch cork stimulates wound healing via induction of basal cell proliferation and promotion of keratinocyte differentiation. A multicenter, prospective, randomized, controlled, clinical trial compared, intra-individually, betuline to a state-of-the-art moist wound healing dressing. As a wound model, split thickness skin was grafted in 16 patients due to plastic surgery. The donor site area at the upper leg was divided into equal halves. By randomization one site was treated with betuline oleogel and the other with moist dressing alone. Treatment continued for 14 days after surgery. Photographs were taken 1 year after treatment and sent to distant experts in a blinded version. The main objective was to compare the 2 areas with different treatment in terms of superior normal skin appearance. After 1 year and with 14 patients in control, superior healing by betuline was evident in 12 of 14 cases, and 9 of 14 patients had obvious esthetic benefit due to betuline, whereas no one performed perfectly by moist dressing alone.