Abstract
Background and objectives: We examined whether there is a significant correlation between inflammatory markers and the wound healing rate (WHR) in diabetic patients. Materials and Methods: A total of 60 patients were divided into two groups depending on the completion of wound healing (WH) at 5 weeks: the early WH group (period of WH < 5 weeks; n = 27) and the late WH group (period of WH > 5 weeks; n = 33). The baseline characteristics and wound measurements were compared between the two groups. To identify the correlation between inflammatory markers (e.g., white blood cell counts (WBCs), serum C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR)) and WHR, we performed a Pearson correlation analysis. Results: The WHR was 8.06 ± 4.02 mm2/day in the early WH group and 2.71 ± 0.88 mm2/day in the late group. This difference reached statistical significance (p < 0.001). Moreover, WBC counts were significantly higher and serum levels of CRP and ESR were significantly lower in the early WH group than in the late group (p = 0.027, 0.036 and 0.043, respectively). Conclusions: Our results indicate that WBC as well as serum CRP and ESR levels have a significant correlation with WHR in diabetic patients.
Highlights
A wound is a loss of skin integrity that arises from injury or disease. It should be healed by repair and regenerative mechanisms because intact skin is an essential element for protecting organisms against the environment, for which restoration of the pre-injured form and skin functions serves as the primary goal of wound healing [4]
Pro-inflammatory responses to tissue injury are involved in the wound healing (WH) process, at a higher degree in chronic impaired wounds than in acute normal ones [35,36]
This is accompanied by a review article reporting that normal WH is characterized by the involvement of a single, transient tissue injury, limited stimulation of inflammatory cytokines, normal epithelialization, the synthesis of extracellular matrix (ECM), angiogenesis and the formation of scar tissue, while impaired WH is characterized by the involvement of a recurrent tissue injury leading to increased actions of pro-inflammatory cytokines [37]
Summary
Skin is the largest human organ; it is composed of epidermis and dermis, and serves as the first line of protection against external invasion [1,2]. Diverse types of GFs, such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and fibroblast growth factors (FGFs), are released and used to promote epidermal repair and angiogenesis. This leads to the synthesis of granulation tissue [8]. Physiological responses to tissue injury in healthy individuals are characterized by timely healing with full reepithelialization, resolution of drainage and restoration of functions [13] This intricate sequence is not seen in patients with chronic wounds; such physiologic events stall in some phases of WH without progression to the following phase. We conducted this retrospective study to examine whether there was a significant correlation between inflammatory markers and WHR in a cohort of patients with T2DM
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