Ethanolic Extract of Etlingera elatior Stems Accelerates Wound Healing in Staphylococcus aureus-Infected Rats

This study evaluated the wound-healing, antimicrobial, and anti-inflammatory efficacy of ethanolic Etlingera elatior stem extract formulated into topical ointments (20% F1, 30% F2, 40% F3) and applied to Staphylococcus aureus–infected excisional wounds in rats. All formulations met physicochemical quality requirements, with pH values ranging from 6.15–6.50 (effect of extract concentration: p < 0.000), adhesiveness from 6.10–8.74 s (p < 0.05), and spreadability 5.23–5.50 cm (p = 0.277). Repeated-measures nonparametric ANOVA demonstrated significant group, time, and interaction effects for wound contraction and bacterial load, indicating treatment-dependent healing trajectories. Extract-treated groups showed markedly faster wound closure than negative and normal controls throughout Days 3–15 (p < 0.05), with F3 consistently demonstrating the earliest transition into the proliferative phase and the most complete epithelial recovery by Day 15. Antimicrobial assessment revealed strong temporal reductions in bacterial counts, with significant group differences on Day 6 (χ² = 22.40, p = 4.39 × 10⁻⁴, ε² = 0.97). All extract formulations exhibited substantially lower CFU/mL than controls, and F1 and F2 surpassed gentamicin in the steepness of decline. Systemic inflammation analysis showed a significant decrease in CRP only in F3 (p = 0.0136), whereas all other groups exhibited nonsignificant changes (p > 0.05). These findings demonstrate that E. elatior extract supports wound healing through a combination of antimicrobial activity, modulation of inflammatory biomarkers, and enhancement of early granulation and re-epithelialization, highlighting its potential as a natural therapeutic alternative for infected skin wounds.