Chronic Wounds may Result from an Imbalanced Wound Bed

Chronic wounds caught in a prolonged inflammatory phase are linked to infection, tissue damage by free radicals & proteases,4-6 and a cycle of wound deterioration maintained by inflammatory mediators.1,7,8   Chronic ulcers are often accompanied by edema, ischemia, or lack of perfusion, impeding the normal delivery of cells and nutrients to the wound bed.9   Imbalances in the relative levels of growth factors, cytokines, and chemokines contribute to chronic wounds. This complexity may explain why single growth factors and growth factor concentrates are incomplete solutions in the management of chronic wounds.7

1 Diegelmann R, Evans MC. Wound Healing: An Overview of Acute, Fibrotic and Delayed Healing. 2004. Frontiers in Bioscience 9:283-289

4 Mast BA, Schultz GS. Interactions of cytokines, growth factors, and proteases in acute and chronic wounds. Wound Repair Regen 1996; 4(4): 411-20

5 James TJ, Hughes MA, Cherry GW, Taylor RP. Evidence of oxidative stress in chronic venous ulcers. Wound Repair Regen 2003; 11(3): 172-6

6 Moseley R, Hilton JR, Waddington RJ, Harding KG, Stephens P, Thomas DW. Comparison of oxidative stress biomarker profiles between acute and chronic wound environments. Wound Repair Regen 2004; 12(4): 419-29

7 Goldman R. Growth Factors and Chronic Wound Healing: Past, Present, and Future. 2004 Adv. Skin Wound Care 17:24-35

8 Ochoa O, Torres FM, Shireman PK. Chemokines and diabetic wound healing.   Vascular 15(6): 350-355. 2007

9 Sussman C, Bates-Jensen B. Wound Care, A collaborative practice manual for health professionals. 2007 3rd edition Lippincott Williams and Wilkins. pp.33-34