State of the Art in Topical Wound-Healing Products

Abstract

Chronic wounds represent a significant medical burden. Such wounds fail to normally progress through the stages of healing, often complicated by a proinflammatory milieu caused by increased proteinases, hypoxia, and bacterial burden. As a result, several modalities, such as dressings, antimicrobials, growth factors, and human skin substitutes, have been devised in an attempt to correct the chronic wound environment. This review addresses these modalities with a focus on evidence and randomized controlled trials.

The Roles of Growth Factors in Keratinocyte Migration

“…There is currently one FDA-approved growth factor treatment for wounds, Regranex Ò (recombinant PDGF-BB), prescribed specifically for diabetic foot ulcers, and clinical trials have been conducted for EGF, GM-CSF, and FGF-2 as well. 4 The limited success of exogenous growth factor therapies could be due to (1) difficulties in delivering biologically active growth factors to the proper target sites in the wound; (2) altered expression (from decreased synthesis or degradation) of growth factors, their receptors, or secondary molecules; or (3) blockade of activation of receptors or secondary molecules necessary for growth factor-mediated signaling in the proteolytic and microbe-rich environment of chronic wounds. The continued identification and investigation of KC-specific motogenic growth factors and the secondary molecules that modulate growth factormediated signaling will, therefore, be important for gaining a better understanding of disease states in which proper KC migration is disrupted, and along…”

The effect of Momordica on wound healing

“…Yara tedavisinin beraberinde getirdiği maddi sorunların yanısıra, iyileşme süresi uzun olan yaralarda, hastalar psikolojik olarak da olumsuz yönde etkilenmektedir. Tüm bu nedenlerden dolayı, yaraların en kısa sürede iyileşmesini sağlamak ve hastaları günlük rutinlerine döndürebilmek amacıyla, yara bakımında kullanılan topikal ajanlar ve yara pansuman malzemelerinin sayısı günümüzde oldukça çeşitlenmiştir [6].…”

Heparan Sulfate Proteoglycan Mimetics Promote Tissue Regeneration: An Overview

“…(Rizzi, Upton et al 2010;Fan, Tang et al 2011)). Briefly, research efforts to establish novel treatments can be categorized in tissue engineered skin based therapies, growth-factor based therapies, extracellular matrix based therapies and combinations thereof.…”

“…Also many reviews exist on this topic (recent examples are e.g. (Rizzi, Upton et al 2010;Fan, Tang et al 2011). …”

“…In the USA the costs related to chronic wounds are estimated over $25 billion a year (Fan, Tang et al 2011). In the European Union the costs related to pressure ulcers and venous ulcers are estimated around €20 billion per year.…”