Asiaticoside, a triterpenoid saponin derived mainly from Centella asiatica (Gotu Kola), has a history of use in traditional medicine for wound healing. In the context of surgery, its use is increasingly supported by scientific studies, although most data are from animal models and small clinical trials rather than large-scale, robust human studies.

Mechanistically, asiaticoside is believed to promote wound healing by stimulating collagen synthesis, enhancing angiogenesis (formation of new blood vessels), and modulating inflammatory responses. Numerous in vitro studies and animal experiments have shown that topical or systemic administration of asiaticoside accelerates wound closure, increases tensile strength of healed tissue, and improves the quality of scar formation. For example, studies in rats have demonstrated faster epithelialization and increased hydroxyproline content (a marker of collagen) in wounds treated with asiaticoside.

Human evidence includes a small number of clinical trials and case reports suggesting benefits in surgical wound healing, scar reduction, and management of hypertrophic scars and keloids. For instance, topical preparations containing asiaticoside have been reported to improve post-surgical scar appearance. However, these studies often have methodological limitations, such as small sample sizes and lack of blinding.

In summary, while traditional use is strong and scientific evidence is growing, the overall quality and quantity of human data are moderate. Therefore, asiaticoside is supported for post-surgical healing with a moderate scientific evidence rating.