A Narrative Review of Cutaneous Wound-Healing Botanicals in South Africa: Integrating Ethnomedicinal Use, Pharmacological Evidence, and Conservation Prioritization

African Traditional Medicine (ATM) remains an important component of primary healthcare in South Africa; however, evidence for plants used in cutaneous wound care is dispersed across ethnobotanical, pharmacological, toxicological, and conservation literature. This narrative review integrates these evidence streams and proposes a conservation- and safety-aware translational prioritization framework for wound-healing botanicals used in South African ethnomedical practice. A structured search of PubMed, ScienceDirect, Web of Science, Google Scholar, and SciFinder identified eligible peer-reviewed ethnobotanical and preclinical studies published between January 1999 and June 2026. After taxonomic harmonization, 173 accepted taxa were documented from South African ethnobotanical reports as being traditionally used for wound care. Only seven taxa had direct wound closure evidence in relevant in vitro or in vivo models, while twenty-eight taxa had wound-relevant anti-inflammatory evidence. Reported mechanisms included keratinocyte and fibroblast migration, collagen-associated responses, angiogenesis, wound contraction, and inflammatory modulation. The evidence base remains uneven: many taxa are supported primarily by traditional use, while dose, formulation, treatment frequency, duration of use, dermal safety, and sustainable sourcing are poorly reported. Safety concerns were identified for selected toxic or irritant taxa, and destructive harvesting of roots, bulbs, corms, rhizomes, and bark may increase conservation risk. Overall, the review highlights a substantial gap between ethnomedical documentation and pharmacological validation, and it provides a prioritization strategy to guide future phytochemical, mechanistic, formulation, dermal-safety, and preclinical wound-healing research in South Africa.