Wound Healing

Abstract

Wound healing normally progresses via a cascade of events beginning with hemostatsis and migration of inflammatory cells, followed by angiogenesis, matrix deposition, epithelial regeneration (in cutaneous and other epithelialised tissues), and remodeling of the newly deposited tissue matrix. In nonhealing or chronic wounds, this process seems to be disrupted and often fails to produce the vascularized granulation tissue needed for tissue repair. Technological advances over the past two to three decades have provided many new approaches to wound therapy. These include novel biomaterials for wound dressings, engineered drugs and drug delivery systems, tissue‐engineered interactive wound coverings, hyperbaric oxygen therapy, nitric oxide releasing agents, and various physical therapies including devices for electrical stimulation and photostimulation. Many of these have reached clinical practice, and some have generated improvements in wound healing rates. Barriers to adoption of new technologies for wound healing include complex application methods, failure to demonstrate significant benefits in animal and clinical trials, and the vast differences between therapies required for different wound types at different stages. Consequently, this extremely crowded market offers a high degree of choice between the many therapies for which there is often insufficient evidence of efficacy. Although traditional therapies such as saline‐soaked gauze persist, the future offers hope in many forms, via better understanding of cell and molecular processes involved in wound healing and combined approaches to therapy.