15 - Wound healing

Abstract

Wound healing is a tightly regulated, dynamic process that allows the body to restore skin integrity. Under normal conditions, wound healing proceeds through four distinct yet overlapping stages: hemostasis, inflammation, proliferation, and maturation. However, many factors can slow this process, such as infection, poor nutrition, limited blood supply, and radiation. When wound healing is impaired, the body cannot restore skin integrity, and chronic wounds form, which can be a source of significant patient morbidity. Similarly, exuberant wound healing leads to the formation of hypertrophic scars and keloids, which are a source of pain, pruritus, and poor aesthetic appearance. Multiple options exist for treating wounds, including correcting the underlying condition and additional interventions, such as surgical debridement with closure, serial dressing changes, and negative pressure wound therapy. A plethora of dressing choices are available to promote wound healing by absorbing exudate, providing a moist wound environment, serially debriding the wound, or serving as an antimicrobial. Novel wound healing research has provided advancements such as growth factor therapy, tissue engineering strategies, stem cell delivery, and gene editing techniques and may improve our ability to determine which wounds will heal without intervention or which ones need early treatment. Understanding these options in wound healing therapies, both currently available and upcoming, is critical in providing the best care for patients with wounds.