Science, medicine, and the future: Healing chronic wounds

Abstract

Greater interest in wound healing is needed to ensure higher standards of basic care. Precise identification of the systemic, local, and molecular factors underlying the wound healing problem in individual patients should allow better tailored treatment. Allogeneic skin grafting and bioengineered skin equivalents are being used successfully in patients with venous leg ulcers and diabetic patients with foot ulcers.

The influence of a PHI-5-loaded silicone membrane, on cutaneous wound healing in vivo

“…Although the underlying working mechanism of PHI-5 was not investigated, some knowledge exists on this subject. The expression of MMP-2 is higher in chronic wounds than in acute wounds [10,14], and the role of MMP-2 in non-healing wounds is thought to be a pathological one [1,[4][5][6][7]. Previous literature postulates that PHI-5 corrects an imbalance of MMPs in the wound area, by lowering the release of MMP-2.…”

“…Systemic risk factors for developing and sustaining a chronic wound can be corrected to some extent. Potential treatments have focused on local aspects, for instance by wound debridement, pressure regulation, application of growth factors, the use of (bio-engineered) skin equivalents, and specific wound dressings [1]. Despite present therapeutical options, healing of these wounds takes much time, effort and money, causing a burden on national health care.…”

Experience With Acerbin® in the Treatment of Problem Wounds

“…КОСТЮЧЁНКА Введение «Проблемные» раны (ПР) остаются одним из дис-куссионных вопросов хирургии как в контексте их де-финиции и классификации, так и с точки зрения па-тогенетических особенностей и лечебной тактики. В литературе для обозначения длительно незаживаю-щих или манифестирующих осложненным раневым процессом ран применяют следующие термины: не-заживающие раны [1][2][3], сложные раны [4][5][6], хрони-ческие раны [7][8][9], трудно излечимые раны [10][11][12]. Несмотря на отсутствие согласованных терминологи-ческих и классификационных подходов, большинство авторов обращают внимание на раны (как острые, так и хронические), которые имеют определенные морфо-функциональные особенности и не реагируют на тра-диционную терапию; перечень эффективных средств для лечения таких ран весьма ограничен.…”

Clinical Evaluation of a Novel Topical Negative Pressure Device in Promoting Healing in Chronic Wounds

“…16 At any one time, there are an estimated 200,000 UK individuals with chronic wounds, including 1 in 7 diabetics who develop diabetic foot ulceration, 0.3% of the population with chronic lower leg ulceration, and *5% of hospital inpatients who develop pressure ulcers. [17][18][19][20] While many of these patients respond to conventional care, approximately one quarter have persisting wounds that take months or even years to heal, if they heal at all, regardless of the etiological basis of their chronic ulcerating disease. 21 While overall healing rates compared to conventional care may not differ, where TNP has been clinically found to be useful is the rate at which healthy granulation tissue can be induced in the wound when compared to conventional care.…”