Endogenous Growth Factor Pathways May Regulate Epidermal Hyperplasia in Chronic Venous Wounds: Modulation by Hydrocolloid Dressings

Abstract

While qualitative aspects of dermal repair differ in wounds of different types, duration, and depths, all wounds must be resurfaced by epidermal keratinocytes before they can be deemed “healed.” Epidermal keratinocytes undergo a series of activation steps in acute wound healing, which are likely to be regulated by autocrine growth control mechanims. The state of epidermal keratinocyte activation in chronic venous wounds is examined in this study in relationship to the correct expression of these changes in acute wound healing. The expression of endogenous growth factor pathways in chronic wounds is presented and changes in the growth activation associated with healing of chronic wounds are studied. The results of this study establish that growth activation of the epidermis is not defective in chronic wounds. The activation of epidermis is likely to be regulated by endogenous keratinocyte cytokine and receptor pathways, suggesting that addition of exogenous epidermal mitogens to chronic wounds is unlikely to further alter epidermal healing. In contrast, some of the therapeutic benefits of hydrocolloid dressings in promoting healing of chronic wounds may be related to their ability to suppress excessive keratinocyte proliferation and activation in chronic wounds.