Background and Aim: One of the complications of diabetes mellitus is diabetic ulcer. Diabetic ulcer is commonly infected by infectious agents, especially methicillin-resistant Staphylococcus aureus (MRSA). This study aimed to evaluate the potential effects of alcoholic extracts of Aloe vera, Apium graveolens, and Sauropus androgynus on promoting wound healing in a diabetic wound infected with MRSA.

Materials and Methods: A total of 60 male Sprague-Dawley rats (6 months old, weighing 250-300 g) were injected with 65 mg/kg body weight of streptozotocin to induce diabetes. On day 7, the backs of the rats were shaved, and two circular wounds (4 mm in diameter) were created on their back, which were infected with MRSA. The rats were divided into six groups: Group I = control, Group II = treated with cream base without extract, Group III = treated with 2% A. vera cream, Group IV = treated with 2% A. graveolens cream, Group V = treated with 2% S. androgynus cream, and Group VI = treated with 2% A. vera + 2% A. graveolens + 2% S. androgynus cream. The wounds were treated twice a day for 14 days. The data were collected on days 7 and 14.

Results: The results showed that all three herbal extracts and their combination decreased wound area and percentage of the wound, increased tensile strength of skin, collagen deposition, vascular endothelial growth factor expression, and skin thickness, and depressed the C-reactive protein profile and cyclooxygenase-2 expression.

Conclusion: A. vera, A. graveolens, and S. androgynus creams can be used as herbal therapies against diabetic wounds infected with MRSA, both as a single and combination treatment.

Keywords: Aloe vera, Apium graveolens, diabetes ulcer, methicillin-resistant Staphylococcus aureus, Sauropus androgynus.