Revisiting Folk Wisdom For Modern Chronic Wound Care

In the constant pursuit of innovation, it’s easy to overlook the wisdom of the past. The scientific method and modern research techniques have brought us much innovation, which can often lead us to dismiss traditional cultural beliefs.

However, sometimes, there are still valuable kernels of truth in the folklore of yesteryear. This holds true in a medical study from Finland, which focused on the traditional use of spruce resin to treat chronic wounds, breathing new life into an age-old therapy.

A Persistent Dilemma

Chronic wounds are defined as wounds that fail to proceed through a normal, timely healing process. While there’s no strictly defined timescale, wounds are typically deemed as chronic if they don’t progress through healing milestones after four weeks to three months. These wounds pose a significant burden on global healthcare systems. They create a significant workload for healthcare personnel, and are costly and difficult to manage. Most of all, though, they impair the quality of life for patients, who suffer these wounds for great lengths of time.

Patients with chronic wounds often suffer from other chronic health conditions such as advanced age, malnutrition, or vascular diseases. These can complicate or exclude treatment options that would otherwise help with the issue. Treatment often becomes a delicate balance between managing the underlying co-morbidities and ensuring effective wound care. Any potential new treatment for chronic wounds could thus help many patients stuck in an uncomfortable medical quagmire.

An Ancient Solution with Modern Potential

Traditional medicine is rife with remedies that have been passed down through generations. Many of these have been studied, and found to be ineffective, snake oil, or simply not very helpful. Many, though, are yet to be thoroughly explored by modern science.

Resin is applied either directly over the wound, or onto a bandage that is then applied. Credit: Jokinen, Sipponen

Among these traditional remedies is the resin of the Norway spruce (Picea abies), a sticky substance that has been used for centuries to treat various ailments. Researchers have turned their attention to this old-world remedy in recent decades, investigating its potential for modern wound care, inspired by its use by past generations.

As it turns out, spruce resin is a complex material, made up of a combination of various resin acids and other compounds known as lignans, which are believed to help plants discourage consumption by herbivores. However, they also have a host of other beneficial properties. These compounds exhibit strong antimicrobial activity, and have been found to promote wound healing and skin regeneration, essential elements in treating chronic wounds.

Of course, modern medicine isn’t about peeling something off a tree, rubbing it on, and hoping it helps. Instead, the research group has been working to quantify the mechanisms of action that make spruce resin a seemingly effective agent when it comes to healing chronic wounds.

The resin was able to prevent bacteria from undergoing mitosis, at times by thickening the cell walls to a significant degree, as seen in the second two images. Credit: Jokinen, Sipponen

Research involved using resin samples to attack colonies of fungi and bacteria in agar plates, with liquid media experiments also conducted. This helped researchers qualify the antimicrobial properties of the resin, and determine which pathogens the resin could effectively fight. Other tests investigated the resin’s ability to protect against Staphylococcus aureus infection, with drug-resistant strains of the harmful bacteria currently causing great concern in hospitals across the world.

Findings bore out that the resin was capable of antimicrobial activity by virtue of the fact it could destroy the cell walls and cell membranes of bacteria. Other potential mechanisms include a disruption of the bacteria cell’s energy supply. Meanwhile, it’s believed the lignan component of the resin may also play a role. These chemicals have anti-oxidative properties which may be helpful, and it’s suspected they may undergo transformation into hormone-like substances in the wound environment via microbial metabolism. It’s believed they may then play a positive role in cellular regeneration in the wound area.

Application techniques were also explored, with the primary method involving spreading resin across a wound area before covering it with a bandage. Alternatively, it can be applied to a bandage and then placed upon a wound. Typically, dressings were left in place for one to three days depending on wound activity.

The research paper also features multiple case studies where patients had excellent outcomes after resin treatment of chronic wounds, some of whom had been suffering for years. The before images make for gory viewing, but the after images show just how valuable this treatment can be. Further supporting this are the results of a 2012 clinical trial, in which all 23 patients successfully had their chronic wounds heal in a mean time of 43 days.

Looking Back To Look Ahead

In many ways, this research represents a meeting point of old and new. It’s a potent reminder that the wisdom of our ancestors can still guide us, that the pursuit of the novel doesn’t always have to mean discarding the old. As the medical community works to tackle the complex issue of chronic wound care, integrating this traditional remedy into modern treatment strategies could offer a much-needed breakthrough.

This blend of traditional knowledge and modern scientific rigor underscores the transformative potential of such research. It speaks to the value of tugging at old threads. Sometimes our forebearers really did know what they were talking about, even if they couldn’t explain it in detailed scientific terms. The healing power of the Norway spruce resin may well mark a significant step forward in chronic wound care, demonstrating how science can breathe new life into old wisdom. This journey from folkloric therapy to potential modern medical marvel continues, with each step bringing us closer to better patient outcomes.

(Header image: Norway Spruce, Norbert Frank, University of West Hungary,

81 thoughts on “Revisiting Folk Wisdom For Modern Chronic Wound Care

      1. Read the article, I have a similar question.
        Can it be any spruce? Or is it just Picea Abies that is showing these properties?

        Maybe be a little bit helpful in your response and not just completely dismissive?

        1. The study covered Norway Spruce and limits its scope to that. Your question is a valid question to pursue in future studies, but the scope of this one is appropriately limited. I will note least some of the compounds are found in other species’ resins. It might be worthwhile researching if other cultures used other spruce or pine species resins in wound care as this study used folk wisdom as a reason to investigate.

          I agree with read the article statement however, it makes it clear the study the study is on the Norway Spruce. I suppose they could have been a little more helpful by doing something like : Read the article, it clearly states “Among these traditional remedies is the resin of the Norway spruce (Picea abies)…”. I suppose it’s because I been in too many discussions that are bogged down by people who cannot be bothered to do a little investigation of the material being discussed, and keep bringing up questions and concerns that are directly unambiguously addressed.

        2. I have used the resin from black (picea Mariana) and white (picea glauca) spruce in wound care on myself, and found them effective. Not chronic wounds though (I have yet to experience any). Tamarack (larix laricina) resin seem to work best of my local conifers though.

          1. There’s another one, common in the East of North America, damn my brain is being uncooperative though… Only thing I can remember right now is it sounds like the name of a European tree regarded as toxic or poisonous, but it’s prefixed with something.

    1. Yeah. There’s scientific method and then there’s natural selection. Folk remedies which actually turn out to be legitimate all follow the latter; many things were thrown against a wall for thousands of years and some things stuck, and time eventually prunes away the ineffective ones which were still kept on for some centuries due to superstition or psychosomatic effects.
      It’s not scientific, but it still does produce true results if the process is massively parallel enough and left to run for a very long time. A lot of middling intellects get stuck on the “not scientific” part, Neil deGrasse Tyson pops into their head and says something insufferably annoying, and they stop thinking.
      On the other hand, similar people often completely ignore the way that the scientific method can be poisoned. It’s not a holy thing, it’s just a process that necessarily has to be undertaken by fallible human beings (certifications are absolutely not protection against fallibility, as anyone who has had to be around PhDs long-term sadly understands). Massive incentive structures and stiflingly expensive experimental set-ups (thus necessitating huge investment from… somebody) can ruin even international peer-reviewed systems.
      MASSIVE amounts of modern drugs are junk, but science supposedly backs them up. Eventually it will self-correct, but these things often take decades or centuries. Which is still admittedly orders of magnitude faster than the natural selection model. As an honest scientist would be required to say, “It’s not perfect—but it’s the best we’ve got.”
      An addendum to that would be “…without having to wait for eons.”

      1. > then there’s natural selection. Folk remedies which actually turn out to be legitimate all follow the latter;

        That’s a very low opinion of people. Almost anybody can put two and two together and reason that if the patient died then the remedy was probably not effective, and vice versa. It’s called folk science, which is not as rigorous or philosophically well defined as “real” science, but nevertheless produces results in much the same way.

      2. I would be interested to hear when exactly do you think science began? When did we stop “throwing things at the wall” and started doing science? By what standards?

        Remember that the modern scientific method, the latest version of it in terms of the philosophy, is quite young. Not even a hundred years.

      3. I had a relative years ago that was harmed by some drug that was supposed to help with bone loss. She actually lost bone from the drug!

        It has been shown by medical research journals that statins used long term result in nutritional deficiencies. Other drugs have been pulled from market after there were too many documented harms caused by them.

        Of course, one must exercise caution with natural remedies since it’s all in the dose. The peer review process is junk these days. The FDA only reviews information given to them by the drug companies. Hey, what could wrong there, right?

    2. Your political direction brained kicked in and terminated thought, despite the fact that no politics were mentioned!
      FDA is still garbage, and even the kinds of people who want universal healthcare and such should be able to recognize that profit motive has undeniably caused regulatory capture. The body is guided by the very entities it is intended to regulate. You don’t need to watch Fox to realize this.

    3. “Instead, the research group has been working to quantify the mechanisms of action that make spruce resin a seemingly effective agent when it comes to healing chronic wounds.”

      IOW, they are looking for something they can patent and charge patients dearly.

      1. Or they’re looking for a way to produce it in quantity without having to rely on potentially inefficient production by trees or other plants, and/or undesirable (and possibly deleterious) secondary ingredients. Artificial production also allows production during seasons when the tree or other plant does not produce the desired substance.

        Take maple syrup as an example; the average sugar maple produces enough sap to make about 1 to 2 liters of maple syrup per season, takes 30 or 40 years to grow to the point where it can start producing, can be used for production for 60 or 70 years, and can only be tapped for a period of 4 to 8 weeks per year depending on the weather. That’s why even bargain brands of real maple syrup start at about $29/litre.

        Now imagine the price of a single aspirin if we had to rely on willow bark or meadowsweet for production.

    4. There is profit in natural therapies, just not the massive and risky potential profit of patented approved drugs.

      Many natural substances are generally recognized as safe (GRAS) and require no expensive approval process. Prepare it properly, don’t adulterate it, put it into a tube or bottle, and sell it. There are over 100 brands of supplements available in the U.S., many of which offer natural substances. These brands are subject to the law, and I presume get occasional government inspections.

      Some of these companies make enough money to sponsor their own research.

    5. “There is no profit in natural therapies”

      Bollocks. Just because you can’t patent something doesn’t mean you can’t make a profit on it.
      Just one example, fitting in the scope of this article: honey. Also used in wound care for at least centuries. Dismissed as a folk remedy, but now a valid and scientifically proven therapeutic option. Ointments and gauzes with honey are commercially available.
      OK, two more examples: maggot therapy, leech therapy. You can look them up yourself.

      1. I’ll add a couple more here. Silver is used as an antibacterial in wound care. You can’t patent an element, but it is impregnated into certain brand-name wound dressings.* Also, pawpaw (papaya) is used as a topical antibacterial.

        *Silver is also included in plenty of overpriced sanke-oil concoctions :-)

  1. I had a gross chronic wound situation involving a pet rabbit that had an abscess. The vet said well you’re going to have to pack the wound twice a day until it heals in from the bottom, and the way you do this is you cut off a little of this sterile bandage and soak it in antibiotic material and jam it into the wound, and oh by the way there is some evidence that if you use honey instead of antibiotic gel, and keep the area around the wound dry, the bottom of the wound will heal in faster at a slightly increased risk of bacterial infection around the mouth of the wound. It took well over a month, close to two, but it did heal up and the rabbit lived another 12 years. (Dwarf rabbits live much, much longer than standard sized rabbits, if you can keep them alive.) That vet also mentioned evergreen tree sap but said that was much harder to apply and there was very little evidence for it, but the mechanisms she mentioned were similar: disruption of the cellular membrane by hyperosmotic solutions, and inhibition of the bacteria’s ability to set up an ionic potential for its metabolic processes.

  2. A related but separate thing I believe has been shown is that some practices were useful in the past but not anymore – for instance, tobacco helped against parasites but you probably don’t have any, so you’re better off without it. Old remedies, natural or otherwise, didn’t always fall out of fashion because they didn’t work – sometimes it was the other effects.

  3. I can personally attest to how effective honey can be for burn care. You can buy honey impregnated gauze patches and they work wonders on fairly severe burns and wounds.

    The spruce resin reminds me of an “old timers” solution for cuts in the swamp – they used pine sap. I’ve tapped yellow pine for sap before and it seems to work alright.

  4. This is a very well written article. Author did their homework. Great reporting great interpretation of a scientific article and great background to put everything in context.

    Tanks for this.
    craig MD

  5. The thing about evidence based medicine, is the evidence.
    If it passes scientific rigour, then it IS medicine.
    If it does not, then it isn’t.
    There is no such thing as “alternative medicine”, “folk medicine”, or even “Traditional Chinese Medicine”.
    Medicine REQUIRES evidence.
    You can’t use the word “medicine” if you don’t meet the definition of it.
    If it can’t be proven to work with good science, then it DOESN’T work.

    This treatment might be great.
    It might help lots of people.
    But good science will determine if it is “medicine” or not.

    1. Flip side of that is that scientific rigour takes time and money and thus money. That opens up the risk of the funding body to not investigate unprofitable medicine, for instance if it freely available, and or works too well and cures the person immediately and thus does not keep returning as a ‘customer’.

      1. this attitude is so offensive to healthcare workers. I’ve worked in healthcare, organic research/Pharma and molecular bio and biochem in basic science and clinical care. No one is avoiding cures to keep “customers”. Do you really think a post doc getting $21k/ year are getting rich by sandbagging results? If Pharma developed a magic one pill “cure” they charge an arm and a leg for it. They don’t sit on it and lock it in a vault after investing billions. That doesn’t even pass the sniff test. One case study I worked directly: next gen HepC meds which are about as close to one pill magic cures as can be expected. They are now widely available. Expensive yeah. But available.
        File that thinning with magic water engines that Big Oil totally has or fake moon landings or any other nonsense.

        1. You are being offended by something the commenter didn’t say. He didn’t say they discovered it and are sitting on it, he said there was no money (presumably patentability) so they won’t generally look at it, big difference, and in fact true for the most part. It is nice to see that there are exceptions now and then.

          1. No, craig was bang-on. Pretending that all medicine or all science are simply big-business is naive and totally disrespecting the people and institutions that persevere and SOLVE our big problems, while no-minds keep creating new ones.

            All this public science-hating.And now democracy-hating. It’s like we long for the Dark Ages or something.

          2. >All this public science-hating.

            It’s a question of authority, because people keep using science as a political tool to say “You can’t be right because you aren’t the scientists.” Such people are shutting off information coming from other sources – even though it might be just as valid and well founded – because it threatens their authority. The “science haters” don’t hate science – they hate the people who try to monopolize science.

          3. Who do you think “they” are that “don’t investigate?” Big Pharma? If you think they are they only group looking for new therapies… I can’t help you. Every undergrad researcher doing it for free or grad student getting paid peanuts or medical student or labs funded by independent non-profits or privately funded cancer hospitals or privately funded children’s hospitals and research centers, oncology centers funded by private mid East billionaires (their names are on the buildings…).
            Also, how do “they” know it works too well and cures people if “they” never investigate it because “they” can’t turn a buck?
            “True for the most part” is just wrong.

          4. Dude: ‘Science reporting’ is the entire problem.

            Most adult technical people will have enough expertise to have had something they understand well float by on the news.
            It’s always garbled, often completely reversing the truth. Always in a clickbait or politically convenient direction.

            The average J school student takes no non-remedial science or math. What they do take, they already didn’t learn in middle school and again in high school.

        2. Novartis developed the anti cancer drug Gleevec but when it showed good results in tests they stopped work on it and shelved it, until an American doctor with several patients in stage 4 intestinal cancer contacted all the drug companies asking if they had anything being worked on that showed good result in killing cancer cells without harming healthy cells. Novartis sent him samples of Gleevec and some other drugs they’d quit work on. He tested them and only Gleevec worked. So he contacted Novartis again and asked if they could make up enough of it to treat all his patients.

          Yup, they could and did. Most of the people he used it on survived. Gleevec has become a very useful treatment for certain types of cancer – but it could have been available several years sooner if Novartis hadn’t made the decision to not seek regulatory approval.

          IIRC the American Dr. was able to use it due to a then new law, “Right to try”. If you’re already >thisclose< to dying anyway, an untested drug that does nothing or makes your condition any worse isn't anything to worry about. If it happens to work, especially if it works very well, then it's a bonus and the medical industry gets to bypass a ton of testing they'd normally have to do before anyone critically ill gets to try it.

          1. i got no dog in that fight but I tried to fact check this with Wikipedia. Not the end all of sources obv but “when they got good results in tests the shelved it”
            is quite different than

            When Novartis tested imatinib in rats, mice, rabbits, dogs, and monkeys in 1996, it was found to have several toxic effects; in particular, results indicating liver damage in dogs nearly stopped drug development completely. However, favorable results in studies with monkeys and in vitro human cells allowed testing to continue in humans.

            I can understand why a huge company may decide that risk ain’t worth it and, admittedly according to wiki “reluctantly” released the trial med to the oncologist . And as noted below you can test alll kinds of stuff in people that are, sadly, gonna die anyway but are altruistic souls.

            I hardly think that is actively shelving an know effective and safe med to avoid curing patients and losing customers.


        3. Evidently, there needs to be a scientific study into the effect of money and profit on the bias of whether studies get done or not. I believe it’s called ‘Lobbying’ where folks loiter in long dark corridors in gov building waiting for a vulnerable official to emerge from their cells.

          I’ve got a good example: Honey bee Varroa mite has been around for over 20 years and very strong anecdotal evidence suggests the local mongrel bees in my part of UK have developed behavioral strategies to combat the mites. It’s made complicated by the fact that a large number of beekeepers prefer to keep more pure bred Italian or Buckfast bees with the perception that they are more productive. There’s a profit making factor in the mix in that the chemical companies sell their products at a profit although there is a cheap and easily accessible low profit chemical called oxallic acid which has proved to be very effective.

          All in all, there’s a number of different lobbying groups exchanging false or distorted info and preventing fully funded research into natural Varroa resistance. Profiteering is probs the major factor with bee breeders making cash from selling pure bred bees, but a study of the effects on all the lobbying on just this one small example would be interesting.

          If anybody’s interested in these bees, check out:

    2. >You can’t use the word “medicine” if you don’t meet the definition of it.

      “1a : a substance or preparation used in treating disease”

      Medicine is medicine regardless of whether it is proven to work – or indeed whether it works at all. It’s the purpose, not the outcome, that defines what is medicine. Saying that only clinically proven medicine IS medicine is begging the question.

    3. And that’s the exact reason we look at these folk remedies, to see if they do qualify as medicine, just because it hasn’t been made by a pharmaceutical company doesn’t mean it’s not worth investigating.

      1. The folk remedies that people have are often the result of repeated trials by many different people over time, such that the remedies that didn’t work are forgotten while the remedies that do work are written down and passed along. In other words, empirical testing and peer review. Science.

        The question is just about whose evidence you trust – authority.

        1. But sometimes people don’t know the reason the remedies work (or have an incorrect idea of how it works). For example the ceremonies of a witch doctor can help in the recovery of his patient, but probably because of the placebo effect and not entireties to the gods, which is why research to understand why and how a treatment works, not just that it works. Also with more knowledge of the function of a treatment the more chance you have of improving it. Tradition and research should walk hand and hand.

          1. You think we actually know why and how all drugs work? Also, what kind of evidence is there for modern psychotherapy that you couldn’t produce for witch doctor ceremonies?

        2. That’s why I regularly practice bleeding. Keeps the humors in balance.

          Folk medicine suffers from shitty peer review. You can’t brag ‘it’s been science all along’ once 99% is disproven.

          False positive pattern matching wetware bug. We find a match, there or not. Only math saves us.

    4. An effective substance is effective regardless of whether we’ve happened to have time and money to study it and understand it or not. You’re hung up on epistemology. People have been necessarily groping around in absence of evidence for hundreds of thousands of years. They’ve gotten a lot of things wrong of course. But the scientific process doesn’t make something so; it merely confirms it (or rather it makes incremental progress towards an arbitrary acceptable level of certainty).
      I swear, a certain type of person has a psychological complex built up around freaking out about medical science in one direction or the other.

  6. Isn’t one of the jobs of tree sap covering wounds in the exterior of the tree? If so then it makes sense that it would have antibacterial and wound healing properties (and I know humans aren’t plants) so this does seem to make sense. And if this does turn out to be true than it’s a great reason to slather yourself in maple syrup.

      1. So, if we get hit by a fungus that threatens mankind,
        As in the video game “The Last of Us”,
        Sap from evergreens 🌲 might be the cure!

    1. >> it’s a great reason to slather yourself in maple syrup.
      Except for the cost. That stuff – the real stuff, not most of what’s sold in grocery stores – is very expensive.

      Hardened tree sap is analagous to a scab on a mammal – it seals an opening in the outer layer of the bark to prevent entry of foreign organisms. Prior to hardening it is very sticky, trapping numerous insects and spores, preventing them from getting to the interior of the tree. The sugar it contains is also a preservative, killing most bacteria in high enough concentrations.

  7. I used to use Stockholm tar for barbed wire cuts on young calves. It sealed the cut and kept infection out. A quick google shows Stockholm tar currently being sold for horses. I imagine this resin is very similar stuff.

    1. Hell, may as well pick some up and throw it into the ol’ first aid kit…
      Will put it next to that powder for hemophiliacs which causes blood to clot into a hard scab in a fraction of a second. That stuff is amazing, even if you don’t have a clotting disorder. Handy for when you need to keep working after a minor cut and don’t wanna smear blood all over the work.

        1. There are various brand names: WoundSeal, Bloodstop, BleedStop are some. Unlike styptics, these contain blood clotting factors. Some also have antibacterial igredients.

  8. The average GP doctor can’t tell you how the pills they push work either, you have to go and ask a research pharmacologist, so things really haven’t changed that much at the messy end of the medical profession. One interesting thing to note is the information incoherence on wikipedia that has pages of plant X claiming that it is useless while mentioning that it contains substance Y, but the page for substance Y does describe how it can be useful. The lesson there is always drill down into a subject if you want the whole truth and to acquire actionable knowledge.

    1. Oftentimes plant X may have substance Y, which is effective, but also has substance Z, which renders substance Y ineffective, or which has an effect more deleterious than the condition substance Y was intended to treat. That would be reason to label plant X ineffective.

      It’s kind of like salt water – we all know we need to consume water to live, but the extra ingredients will kill you quicker than dehydration will.

      1. That may be a reason, but it isn’t the reason in most cases. Furthermore we have extraction and separation processes such as distillation as options too. Just water vs ethanol will pull different molecules out of medicinal mushrooms.

    1. Been using Petro-Carbo for a decade to help with cuts and scrapes… it has spruce oil in it.

      Once I became a diabetic wounds stopped healing as fast but a bit of salve seems to work wonders. Don’t know that I would use it in a gaping wound, but the doctor putting in stitches probably won’t give me choice in the matter😁.

  9. “Many of these have been studied, and found to be ineffective, snake oil, or simply not very helpful.” you missed the last group, downright lethal. Thinking of stuff like mercury or radium as being used for cures.

  10. Someone once told me about a student whose thesis was on medicines and medicinal plants used in South America during the 16th century (european accounts). After some time a big pharma company, paid him to find more of these reports. Many drugs were discovered by accident under conditions almost impossible to reproduce at random. The company’s interest in these reports makes some sense.

Leave a Reply

Please be kind and respectful to help make the comments section excellent. (Comment Policy)

This site uses Akismet to reduce spam. Learn how your comment data is processed.