The Skin and the Physiology of Normal Wound Healing

2020 ◽  
Author(s):  
Timothy W. King ◽  
Sahil K. Kapur

This review presents normal wound healing as a complex process that is generally carried out in three overlapping stages: an inflammatory phase, a proliferative phrase (made up of fibroplasia, contraction, neovascularization, and granulation), and a remodeling phase. In addition, wound healing occurs under the influence of multiple cytokines, growth factors, and extracellular matrix signals. Figures show the layers of the skin and the cycles of wound healing.  This review contains 6 highly rendered figures, 8 tables, and 47 references Keywords: wound, wound care, healing, epithelialization, migration, granulation

2020 ◽  
Author(s):  
Timothy W. King ◽  
Sahil K. Kapur

This review presents normal wound healing as a complex process that is generally carried out in three overlapping stages: an inflammatory phase, a proliferative phrase (made up of fibroplasia, contraction, neovascularization, and granulation), and a remodeling phase. In addition, wound healing occurs under the influence of multiple cytokines, growth factors, and extracellular matrix signals. Figures show the layers of the skin and the cycles of wound healing.  This review contains 6 highly rendered figures, 8 tables, and 47 references Keywords: wound, wound care, healing, epithelialization, migration, granulation


2002 ◽  
Vol 4 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Beverly B. Childress ◽  
Joyce K. Stechmiller

Chronic wounds mainly affect elderly individuals and persons with comorbid diseases due to a compromised immune status. An age-related decline in immune function deters proper healing of wounds in an orderly and timely manner. Thus, older adults with 1 or more concomitant illnesses are more likely to experience and suffer from a nonhealing wound, which may drastically decrease their quality of life and financial resources. Novel therapies in wound care management rely heavily on our current knowledge of wound healing physiology. It is well established that normal wound healing occurs sequentially and is strictly regulated by pro-inflammatory cytokines and growth factors. A multitude of commercial products such as growth factors are available; however, their effectiveness in healing chronic wounds has yet to be proven. Recently, investigators have implicated nitric oxide (NO) in the exertion of regulatory forces on various cellular activities of the inflammatory and proliferative phases of wound healing. Gene therapy in animal studies has shown promising results and is furthering our understanding of impaired wound healing. The purpose of this article is to review the literature on NO and its role in wound healing. A discussion of the physiology of normal healing and the pathophysiology of chronic wounds is provided.


2012 ◽  
Vol 45 (02) ◽  
pp. 220-228 ◽  
Author(s):  
Shah Jumaat Mohd. Yussof ◽  
Effat Omar ◽  
Dinker R. Pai ◽  
Suneet Sood

ABSTRACTResearchers have identified several of the cellular events associated with wound healing. Platelets, neutrophils, macrophages, and fibroblasts primarily contribute to the process. They release cytokines including interleukins (ILs) and TNF-α, and growth factors, of which platelet-derived growth factor (PDGF) is perhaps the most important. The cytokines and growth factors manipulate the inflammatory phase of healing. Cytokines are chemotactic for white cells and fibroblasts, while the growth factors initiate fibroblast and keratinocyte proliferation. Inflammation is followed by the proliferation of fibroblasts, which lay down the extracellular matrix. Simultaneously, various white cells and other connective tissue cells release both the matrix metalloproteinases (MMPs) and the tissue inhibitors of these metalloproteinases (TIMPs). MMPs remove damaged structural proteins such as collagen, while the fibroblasts lay down fresh extracellular matrix proteins. Fluid collected from acute, healing wounds contains growth factors, and stimulates fibroblast proliferation, but fluid collected from chronic, nonhealing wounds does not. Fibroblasts from chronic wounds do not respond to chronic wound fluid, probably because the fibroblasts of these wounds have lost the receptors that respond to cytokines and growth factors. Nonhealing wounds contain high levels of IL1, IL6, and MMPs, and an abnormally high MMP/TIMP ratio. Clinical examination of wounds inconsistently predicts which wounds will heal when procedures like secondary closure are planned. Surgeons therefore hope that these chemicals can be used as biomarkers of wounds which have impaired ability to heal. There is also evidence that the application of growth factors like PDGF will help the healing of chronic, nonhealing wounds.


2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Pawel Olczyk ◽  
Łukasz Mencner ◽  
Katarzyna Komosinska-Vassev

Wound healing is the physiologic response to tissue trauma proceeding as a complex pathway of biochemical reactions and cellular events, secreted growth factors, and cytokines. Extracellular matrix constituents are essential components of the wound repair phenomenon. Firstly, they create a provisional matrix, providing a structural integrity of matrix during each stage of healing process. Secondly, matrix molecules regulate cellular functions, mediate the cell-cell and cell-matrix interactions, and serve as a reservoir and modulator of cytokines and growth factors’ action. Currently known mechanisms, by which extracellular matrix components modulate each stage of the process of soft tissue remodeling after injury, have been discussed.


2019 ◽  
Vol 8 (2) ◽  
pp. 124-133
Author(s):  
Mukhammad Toha ◽  
Mokh Sujarwadi ◽  
Ida Zuhroidah

Background: Older adult patients who underwent hernia surgery commonly get obstacles in the process of wound healing as a result of decline of body functions. Aloe vera which contains of anti-inflammatory, anti-microbial and skin fibroblasts stimulator, can be used as adjunctive therapy in treating wounds.Objective: This study aimed to identify the effect of aloe vera extract and discharge planning to accelerate wound healing of older adult hernia surgery patients at dr. R. Soedarsono General Hospital, Pasuruan.Method: This study uses Quasi-Experimental with Static-group comparison approach. The population is all post-operative hernia patients aged 55-65 years at the operating room of dr. R. Soedarsono General Hospital, Pasuruan. The sample consists of 20 respondents taken according to the inclusion criteria. The independent variable is the treatment of wounds using aloe vera extract accompanied by discharge planning, while the dependent variable was the acceleration of wound healing especially inflammatory and proliferation phases. The data were collected through observation of macroscopic current wound care. Data were analyzed using nonparametric Mann Whitney test with significance level of < 0.05.Result: The results showed the effect of the treatment using aloe vera extract and discharge planning to accelerate wound healing of older adult hernia surgery patients, the inflammatory phase of healing occurs on the sixth day for inflammation, exudation, and edema (p = 0.022, p = 0.028, and p = 0.029, respectively). The proliferative phase occurs on day three with p = 0.015.Conclusion: This research indicates further research on the benefits of aloe vera and discharge planning for wound healing especially in older adult patients is required. Thus, a stronger basis for recommending aloe vera extract as complementary therapy for wound care is available. Key words: Aloe Vera, Discharge Planning, Surgical Wound, Older Adults Age.


2018 ◽  
Vol 4 (2) ◽  
pp. 109
Author(s):  
Mufimah Mufimah ◽  
Uti Rusdian Hidayat ◽  
Ichsan Budiharto

Abstract: Efectiveness Gel Extract Of White On The Process Of Healing Inflamation Phase Heating. The inflammatory phase is a favorable body response as a protection mechanism. In the process of wound healing becomes a very important phase. Management of inflammation that is often used Non-Steroid Anti-Inflammatory class of salicylates on the skin that have side effects. The content of allicin in garlic can be used for problems that begin with the inflammatory phase. The use of gel from garlic extract is also easier to use and easier to clean. The study aim to determine the effectiveness of garlic extract gel to process wound inflammatory phase healing. This research is an experimental research with pre and post test with control group method with 24 samples. Conducted injury to the back area of rat length of wound 1 cm, depth to dermis. Conducted wound care, given gel extract of garlic concentration of 20%, 40%, 80% of the control using 0.9% NaCl compress. Using Kruskal Wallis test and Anova oneway showed concentration of 20%, 40%, and 80% of sig <0,05 ie 0.00. It was concluded that 20%, 40%, 80% garlic extract gel was effective against inflammatory wound healing process. The use of garlic extract gel is more effective in the wound inflammatory wound healing process.Abstrak: Efektivitas Gel Ekstrak Bawang Putih  terhadap Proses Penyembuhan Luka Fase Inflamasi.  Fase inflamasi merupakan respon tubuh yang menguntungkan sebagai mekanisme perlindungan. Pada proses penyembuhan luka menjadi fase yang sangat penting. Penatalaksanaan inflamasi yang sering digunakan Anti-Inflamasi Non Steroid golongan salisilat pada kulit yang memiliki efek samping. Kandungan zat allicin pada bawang putih dapat dimanfaatkan untuk masalah yang diawali dengan fase inflamasi. Pemanfaatan gel dari ekstrak bawang putih pun dalam penggunaannya lebih mudah diabsorsi dan mudah dibersihkan. Penelitian ini bertujuan untuk mengetahui efektifitas gel ekstrak bawang putih terhadap proses penyembuhan luka fase inflamasi. Penelitian ini merupakan penelitian eksperiment dengan metode pre and post test with control grup dengan jumlah sampel sebanyak 24 ekor tikus. Dilakukan perlukaan pada daerah punggung tikus panjang luka 1 cm, kedalaman sampai dermis. Dilakukan perawatan luka, diberi gel ekstrak bawang putih konsentrasi berbeda yaitu 20%, 40%, 80%  kontrol menggunakan kompres NaCl 0,9%. Hasil uji Kruskal Wallis dan Anova oneway menunjukkan konsentrasi 20%, 40%, dan 80%  nilai sig <0,05 yaitu 0,00. Disimpulkan bahwa 20%, 40%, 80% gel ekstrak bawang putih efektif terhadap proses penyembuhan luka inflamasi. Penggunaan gel ekstrak bawang putih lebih efektif dalam proses penyembuhan luka inflamasi luka.   Disimpulkan bahwa 20%, 40%, 80% gel ekstrak bawang putih efektif terhadap proses penyembuhan luka inflamasi. Penggunaan gel ekstrak bawang putih lebih efektif dalam proses penyembuhan luka inflamasi luka.


2021 ◽  
Author(s):  
Priyanka Chhabra ◽  
Kajol Bhati

Abnormal wound healing represents a major healthcare issue owing to upsurge number of trauma and morbid physiology which ultimately posed a healthcare burden on patient, society and health care organization. A wound healing is a complex process so effective management of chronic wounds is often hard. Recently in addition to many conventional wound treatment’s advances in bionanomaterial are attaining much attention in wound care and skin tissue engineering. Bionanomaterials are biomolecule-based nanocomposite synthesized by plants, microbes and animals which possess high degree of biocompatibility, biodegradability, non-toxicity and bioactive assets. Bioactive assets like antimicrobial, immune modulatory, cell proliferation and angiogenesis of biomolecules forms fortunate microenvironment for the wound healing process. Nature has provided us with a significant set of biomolecules like chitosan, hyaluronic acid, collagen, cellulose, silk fucoidan etc. have been exploited to construct engineered bionanomaterials. These biopolymeric nanomaterials are currently researched comprehensively as they have higher surface to volume ratio and high chemical affinity showing a promising augmentation of deadly wounds. In this chapter we aimed to highlight the biological sources and bioengineering approaches adapted for biopolymers so they facilitate wound healing process.


Author(s):  
Swathi Balaji ◽  
Abdul Q. Sheikh ◽  
Lee Morris ◽  
Foong Y. Lim ◽  
Timothy M. Crombleholme ◽  
...  

Chronic ulcers are a leading cause of morbidity in diabetic patients. Diabetes is associated with major changes in the wound microenvironment and disruption of normal wound healing process, characterized by a prolonged inflammatory phase with elevated levels of wound proteases and increased degradation of extracellular matrix (ECM) components [1]. This impedes wound healing due to a lack of provisional matrix, impaired recruitment and survival of endothelial (EC) and endothelial precursor (EPC) cells, and insufficient neovascularization, resulting in delayed healing. Therefore, strategies focused on restoring the diabetic wound microenvironment by decreasing ECM degradation and promoting neovascularization are promising for development of new therapies to treat chronic diabetic ulcers.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Jinying Liu ◽  
Dezhi Sun ◽  
Jiale Liu ◽  
Hao Xu ◽  
Yuan Liu ◽  
...  

Background. Fibrosis is a highly dynamic process caused by prolonged injury, deregulation of the normal processes of wound healing, and extensive deposition of extracellular matrix (ECM) proteins. During fibrosis process, multiple genes interact with environmental factors. Over recent decades, tons of fibrosis-related genes have been identified to shed light on the particular clinical manifestations of this complex process. However, the genetics information about fibrosis is dispersed in lots of extensive literature. Methods. We extracted data from literature abstracts in PubMed by text mining, and manually curated the literature and identified the evidence sentences. Results. We presented FibroAtlas, which included 1,439 well-annotated fibrosis-associated genes. FibroAtlas 1.0 is the first attempt to build a nonredundant and comprehensive catalog of fibrosis-related genes with supporting evidence derived from curated published literature and allows us to have an overview of human fibrosis-related genes.


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