Aging and Wound Healing

Gosain, Ankush; DiPietro, Luisa A.

doi:10.1007/s00268-003-7397-6

Cited by 843 publications

(570 citation statements)

References 107 publications

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“…Pathological changes in the skin often correlate with changes in tissue elasticity [32]. The process of wound healing in the elderly is altered and delayed [33], and increasing age has been shown to result in increased skin stiffness [34]. In our baboon model we demonstrate a similar effect of increased stiffness in the diabetic healed skin incision site, which is likely to be due to increased cross-linking of skin collagen.…”

Section: Discussionsupporting

confidence: 60%

A novel primate model of delayed wound healing in diabetes: dysregulation of connective tissue growth factor

et al. 2009

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Aims/hypothesis Chronic non-healing wounds are a common complication of diabetes. Prolonged inflammation and decreased matrix accumulation may contribute. Connective tissue growth factor (CTGF) is induced during normal wound healing, but its regulation in diabetic wounds is unknown. We developed a primate model for the study of in vivo wound healing in baboons with long diabetes duration. Methods Drum implants were placed subcutaneously into thighs of diabetic and non-diabetic control baboons. After 2 and 4 weeks the skin incision sites were removed for measurement of breaking strength and epithelial thickness.Drum implants were removed for analysis of granulation tissue and inflammatory cells, CTGF and tissue inhibitor of matrix metalloproteinase (TIMP-1). Degradation of added CTGF by wound fluid was also examined. Results Healed incision site skin was stiffer (less elastic) in diabetic baboons and epithelial remodelling was slower compared with controls. Granulation tissue from diabetic baboons was reduced at 2 and 4 weeks, with increased vessel lumen areas at 4 weeks. Macrophages were reduced while neutrophils persisted in diabetic tissue. In diabetic wound tissue at 4 weeks there was less CTGF induced, as shown by immunohistochemistry, compared with controls. In contrast, Electronic supplementary material The online version of this article

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Section: Discussionsupporting

confidence: 60%

A novel primate model of delayed wound healing in diabetes: dysregulation of connective tissue growth factor

et al. 2009

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“…Macrophages play a major role not only in the initial phases of the inflammatory response but also in the growth phase, by secreting angiogenic and fibrogenic growth factors that repair damaged tissue. Studies in human and rodent species have shown an age-related decline in the cutaneous wound repair process, which impacts on the inflammatory response and the growth phase of the repair process (reviewed by Thomas, 2001;Gosain & DiPietro, 2004). The changes reported in both systems are qualitative and they include enhanced platelet aggregation, delayed re-epithelialization, delayed angiogenesis, delayed collagen deposition, turnover and remodelling, delayed healing strength, decreased wound strength, and delayed infiltration and function of macrophages.…”

Section: Wound Repairmentioning

confidence: 99%

Innate immunity in aging: impact on macrophage function

et al. 2004

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SummaryInnate and adaptive immune functions decline with age, leading to increased susceptibility to infectious diseases and cancer, and reduced responses to preventive vaccination in the elderly population. Macrophages function as 'pathogen sensors' and play an important role in the initiation of inflammatory responses, elimination of pathogens, manipulation of the adaptive immune response and reparation of damaged tissue. In this paper, we review the literature addressing the impact of aging on the macrophage population.

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“…Haemostasis and inflammation are the initial events involving multi-cellular chemotaxis followed by proliferation and remodelling phases [12]. Sternal instability may have an adverse impact on wound healing phases by delaying haemostasis and prolonging inflammation as well as disrupting formation of the extra-cellular matrix and epithelialization.…”

Section: Discussionmentioning

confidence: 99%

Does the number of wires used to close a sternotomy have an impact on deep sternal wound infection?

Shaikhrezai

Robertson

Anderson

et al. 2012

Interactive CardioVascular and Thoracic Surgery

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OBJECTIVES:We studied the influence of the number of sternotomy mechanical fixation points on deep sternal wound infection (DSWI). METHODS:Between September 2007 and February 2011, 2672 patients underwent a standard peri-sternal wire closure following a median sternotomy for a first-time cardiac surgery. Data were collected during the study period. RESULTS:The mean age of the patients was 66 ± 11 and 1978 (74.0%) were male. The mean body mass index (BMI) was 28.9 ± 9.3 and the median of the logistic EuroSCORE was 3.14, with a range of 0.88-54.1. Postoperatively, 40 (1.5%) patients developed DSWI after 14 ± 6 days, of whom 39 (92.5%) had positive deep sternal wound specimen cultures, predominantly Staphylococci (62.5%). The risk of DSWI was significantly increased in patients in whom eight or fewer paired points of sternal wire fixation were used when compared with patients in whom nine or more paired points of fixation were used (P = 0.002). Preoperative myocardial infarction (P = 0.001), elevated BMI (P = 0.046), bilateral internal mammary artery harvest (P < 0.0001), postoperative hypoxia (P < 0.0001), sepsis (P = 0.019) and postoperative inotrope use (P = 0.007) significantly increased the risk of DSWI.CONCLUSIONS: DSWI is associated with hypoxia, ischaemia, sepsis and mechanical sternal instability. DSWI may be prevented by using nine or more paired fixation points when closing with standard peri-sternal wires.

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Aging and Wound Healing

Cited by 843 publications

References 107 publications

A novel primate model of delayed wound healing in diabetes: dysregulation of connective tissue growth factor

A novel primate model of delayed wound healing in diabetes: dysregulation of connective tissue growth factor

Innate immunity in aging: impact on macrophage function

Does the number of wires used to close a sternotomy have an impact on deep sternal wound infection?

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